Jennifer Deslich, O.T.

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

OT005828 Issued in GA

Practice address

165 Ridgecrest Cir Ste B
Clayton, GA 30525-4196

Phone

(678) 357-5849

Fax

(706) 534-6750

NPI assigned

Jan 8, 2014

Last updated

Sep 27, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

Specialty

Occupational Therapist in Private Practice

Education

Other, 2013

Medicare assignment

May accept Medicare assignment

Group practices

Fundamental Therapy Services LLCGroup PAC ID 4789936113, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Fundamental Therapy Services, LLC

  • Occupational Therapist
  • Clayton, GA
  • NPI 1780110155
  Medicare reassignment Care Compare group NPD Authorized official

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

{
    "created_epoch": "1389139200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695772800000",
    "number": "1790107993",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4649 E WOLF CREEK RD",
            "city": "TIGER",
            "state": "GA",
            "postal_code": "305762946",
            "telephone_number": "678-357-5849"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "165 RIDGECREST CIR STE B",
            "city": "CLAYTON",
            "state": "GA",
            "postal_code": "305254196",
            "telephone_number": "678-357-5849",
            "fax_number": "706-534-6750"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DESLICH",
        "first_name": "JENNIFER",
        "credential": "O.T.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-01-08",
        "last_updated": "2023-09-27",
        "certification_date": "2023-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XF0002X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Feeding, Eating & Swallowing",
            "state": "NC",
            "license": "15112",
            "primary": false
        },
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "NC",
            "license": "15112",
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "GA",
            "license": "OT005828",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Danny Stevens Hammons (Home Respiratory Services)
• Tracy Ellen Dasher
• James Todd Davidson, CARES, CPS-AD
• Patti Denike, NCTMB THERAPIST
• Dental Professionals of Georgia, P.C. (Dental Care of Clayton)
• Veronica Dono, P.T.
• Kathy Donovan
• Allison Dooley, MD
• Dosher Physical Therapy Associates, Inc
• Abraham Jacob Duncan, PHARM D

• Occupational Therapist in Clayton, GA
• Providers in Clayton, GA by specialty
• Occupational Therapist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2023; 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.