NPIMap

Organization Active NPI

Your Aging Therapist LLC

  • Occupational Therapist
  • Martinez, GA
National Provider Identifier
1780263129
Registry record updated Sep 28, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
Legal business name
YOUR AGING THERAPIST LLC
Practice address
226 Kestwick Dr W
Martinez, GA 30907-1686
Phone
(706) 495-8796
NPI assigned
Apr 5, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 28, 2021

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

Authorized official

Name
Jennifer Leigh HuffNPI 1184707945
Title
Owner
Phone
(706) 252-9184

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225X00000X Primary

Addresses

Primary practice location

226 Kestwick Dr W
Martinez, GA 30907-1686

Mailing address

226 Kestwick Dr W
Martinez, GA 30907-1686

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA, SC2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20210701003590 GA Part B Supplier - Physical/Occupational Therapy Group in Private Practice 6709285992 Receives reassigned benefits from 12 practitioners
Practice locations: Martinez, GA
O20240315003661 SC Part B Supplier - Physical/Occupational Therapy Group in Private Practice 6709285992 Receives reassigned benefits from 5 practitioners
Practice locations: North Augusta, SC

National Provider Directory

National Provider Directory

Locations

3712 Executive Center Dr
Ste A
Martinez, GA 30907
Phone (706) 252-3332

Practitioners & affiliated clinicians

Practitioners 13

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1617580800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1632787200000",
    "number": "1780263129",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "226 KESTWICK DR W",
            "city": "MARTINEZ",
            "state": "GA",
            "postal_code": "309071686"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "226 KESTWICK DR W",
            "city": "MARTINEZ",
            "state": "GA",
            "postal_code": "309071686",
            "telephone_number": "706-495-8796"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "YOUR AGING THERAPIST LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-04-05",
        "last_updated": "2021-09-28",
        "certification_date": "2021-09-28",
        "status": "A",
        "authorized_official_last_name": "HUFF",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_middle_name": "LEIGH",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "706-252-9184"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Martinez, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.