Individual provider Active NPI

Michelle Raphael Blum

  • Hand Occupational Therapist
  • Atlanta, GA
National Provider Identifier
1790315950
Registry record updated Sep 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hand Occupational TherapistTaxonomy code 225XH1200X
License
OT007601 Issued in GA
Practice address
2061 Peachtree Rd NW #500, Atlanta, Ga 30309
Atlanta, GA 30309-1446
Phone
(404) 352-3522
NPI assigned
Jan 16, 2020
Last updated
Sep 18, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 18, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X OT007601 GA
Occupational Therapist 225X00000X 0119009488 VA
Hand Occupational Therapist 225XH1200X OT007601 GA Primary

Addresses

Primary practice location

2061 Peachtree Rd NW #500, Atlanta, Ga 30309
Atlanta, GA 30309-1446

Mailing address

2061 Peachtree Rd NW
Atlanta, GA 30309

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200619001135 GA Practitioner - Occupational Therapist in Private Practice 1759703713 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Georgia Hand , Shoulder and Elbow PCGroup PAC ID 5193712982, 22 clinicians

Practice addresses (Care Compare)

2061 Peachtree Rd NE
Suite 500
Atlanta, GA 30309-1446
Phone 40435235221026

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0119009488VAMDOccupational Therapist
OT007601GAMDHand Occupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Georgia Hand , Shoulder & Elbow PC CurrentSince Dec 5, 2024 Accepting new patients
Atlanta Hand Therapy, LLC Occupational Therapist CurrentSince Jun 10, 2020 Accepting new patients
Atlanta Hand Therapy, LLC Occupational Therapist CurrentSince Jun 10, 2020 Accepting new patients
Let's Talk Therapy Occupational Therapist PastSince Jan 1, 2020 Accepting new patients

Locations

2061 Peachtree Rd NE
Ste 500
Atlanta, GA 30309
Phone (404) 352-3522

201 Kimberly Way
Ste 102
Canton, GA 30114
Phone (678) 214-6960

3968 Felton Hill Rd SW
Ste 100
Smyrna, GA 30082
Phone (678) 214-6960

3968 Felton Hill Rd SW
Ste 220
Smyrna, GA 30082
Phone (678) 214-6960

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/5080/brand/2/csg/22/fhir/r4

Organizations & group practices 4

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": "1579132800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726617600000",
    "number": "1790315950",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2061 PEACHTREE RD NW",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "30309"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2061 PEACHTREE RD NW #500, ATLANTA, GA 30309",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303091446",
            "telephone_number": "404-352-3522"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLUM",
        "first_name": "MICHELLE",
        "middle_name": "RAPHAEL",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-01-16",
        "last_updated": "2024-09-18",
        "certification_date": "2024-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "GA",
            "license": "OT007601",
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "VA",
            "license": "0119009488",
            "primary": false
        },
        {
            "code": "225XH1200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Hand",
            "state": "GA",
            "license": "OT007601",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2024; 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.