Individual provider Active NPI

Johanna Grose, OT

  • Occupational Therapist
  • Antioch, TN
National Provider Identifier
1760036289
Registry record updated Aug 1, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
OT6209 Issued in TN
Practice address
889 Bell Rd Ste a
Antioch, TN 37013-3101
Phone
(800) 381-2195
Fax
(888) 381-0822
NPI assigned
Aug 1, 2019
Last updated
Aug 1, 2019By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 1, 2019

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 OT6209 TN Primary

Addresses

Primary practice location

889 Bell Rd Ste a
Antioch, TN 37013-3101

Mailing address

4500 Satellite Blvd Ste 2250
Duluth, GA 30096-5047
Phone (800) 381-2195

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
OT6209TNMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Let's Talk Therapy at Antioch, LLC Occupational Therapist CurrentSince Mar 21, 2021 Accepting new patients
Let's Talk Therapy, LLC PastSince Aug 6, 2019 Accepting new patients
K's Therapies, LLC Occupational Therapist PastSince Sep 1, 2019 Accepting new patients

Locations

889 Bell Rd
Ste A
Antioch, TN 37013
Phone (615) 730-6464

Organizations & group practices 3

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": "1564617600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1564617600000",
    "number": "1760036289",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4500 SATELLITE BLVD STE 2250",
            "city": "DULUTH",
            "state": "GA",
            "postal_code": "300965047",
            "telephone_number": "800-381-2195",
            "fax_number": "888-381-0822"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "889 BELL RD STE A",
            "city": "ANTIOCH",
            "state": "TN",
            "postal_code": "370133101",
            "telephone_number": "800-381-2195",
            "fax_number": "888-381-0822"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GROSE",
        "first_name": "JOHANNA",
        "credential": "OT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-08-01",
        "last_updated": "2019-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "TN",
            "license": "OT6209",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Antioch, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.