Individual provider Active NPI

Sonia Brodeur-Lyons, OT

  • Occupational Therapist
  • Savannah, GA
National Provider Identifier
1740598465
Registry record updated Sep 15, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
OT005127 Issued in GA
Practice address
210 E Derenne Ave
Savannah, GA 31405-6736
Phone
(912) 644-5300
Fax
(912) 644-5260
NPI assigned
Sep 15, 2010
Last updated
Sep 15, 2010By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 15, 2010

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X OT005127 GA Primary

Addresses

Primary practice location

210 E Derenne Ave
Savannah, GA 31405-6736

Mailing address

210 E Derenne Ave
Savannah, GA 31405-6736
Phone (912) 644-5300

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120207000323 SC Practitioner - Occupational Therapist in Private Practice 1557345295 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Orthosc LLCGroup PAC ID 8022370030, 113 clinicians

Practice addresses (Care Compare)

210 Village Ctr Blvd
Suite 100
Myrtle Beach, SC 29579-6706
Phone (843) 491-4937

Merit-based Incentive Payment System (MIPS)

Final score
97.45 of 100Reported as group
Promoting interoperability
97
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3838SCMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Orthosc, LLC CurrentSince Apr 1, 2018 Accepting new patients
Greenville Proaxis Therapy, LLC Occupational Therapist CurrentSince Oct 1, 2019 Accepting new patients
Greenville Proaxis Therapy LLC Occupational Therapist CurrentSince Oct 1, 2019 Accepting new patients
Orthosc, LLC CurrentSince Apr 1, 2018 Accepting new patients
Indigo Therapy Specialists, LLC Past Accepting new patients
Orthosc, LLC PastSince May 29, 2022 Accepting new patients
JLC Rehab, Inc. Past Accepting new patients

Locations

790 Remington Blvd
Bolingbrook, IL 60440

33205 Collection Ctr Dr
Chicago, IL 60693

235 Singleton Ridge Rd
Ste 102
Conway, SC 29526

2376 Cypress Cir
Ste 300
Conway, SC 29526
Phone (843) 347-7222

103 N Main St
Ste 201
Greenville, SC 29601
Phone (864) 528-5753

3545 Highway 17
Unit 200
Murrells Inlet, SC 29576
Phone (843) 294-1941

210 Village Center Blvd
Ste 100
Myrtle Beach, SC 29579
Phone (843) 491-4937

210 Village Center Blvd
Ste 200
Myrtle Beach, SC 29579
Phone (843) 236-3222

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/17161/brand/1/csg/1/fhir/r4

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1284508800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1284508800000",
    "number": "1740598465",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "210 E DERENNE AVE",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "314056736",
            "telephone_number": "912-644-5300",
            "fax_number": "912-644-5260"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210 E DERENNE AVE",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "314056736",
            "telephone_number": "912-644-5300",
            "fax_number": "912-644-5260"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRODEUR-LYONS",
        "first_name": "SONIA",
        "credential": "OT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-09-15",
        "last_updated": "2010-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "GA",
            "license": "OT005127",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Savannah, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.