Individual provider Active NPI

Jake Parham, OTR/L

  • Hand Occupational Therapist
  • Fayetteville, GA
National Provider Identifier
1790324101
Registry record updated Jun 30, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hand Occupational TherapistTaxonomy code 225XH1200X
License
OT008793 Issued in GA
Practice address
1275 Highway 54 W Ste 200
Fayetteville, GA 30214-4538
Phone
(770) 460-8609
NPI assigned
Jan 2, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 30, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Technician 106S00000X
Pediatric Occupational Therapist 225XP0200X OT008793 GA
Hand Occupational Therapist 225XH1200X OT008793 GA Primary

Addresses

Primary practice location

1275 Highway 54 W Ste 200
Fayetteville, GA 30214-4538

Mailing address

1200 Corporate Dr Ste 400
Hoover, AL 35242-5424

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250714003530 GA Practitioner - Occupational Therapist in Private Practice 4183139678 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Benchmark Physical Therapy, IncGroup PAC ID 1557395209, 69 clinicians

Practice addresses (Care Compare)

1275 Hwy 54 W 200
Fayetteville, GA 30214-4538
Phone (770) 460-8609

7130 Mount Zion Blvd
Suite 9
Jonesboro, GA 30236-2566
Phone (770) 603-5660

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OT008793GAMDHand Occupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Agilitas USA Inc CurrentSince Jun 30, 2025 Accepting new patients
Independent Physical Therapy of Georgia, LLC Hand CurrentSince Jun 30, 2025 Accepting new patients
Atlanta South Physical Therapy, Inc CurrentSince Jun 30, 2025 Accepting new patients
Agilitas USA, Inc Hand CurrentSince Jun 30, 2025 Accepting new patients
Benchmark Physical Therapy, Inc CurrentSince Jun 30, 2025 Accepting new patients
Independent Physical Therapy of Georgia, LLC Hand CurrentSince Jun 30, 2025 Accepting new patients

Locations

1200 Corporate Dr
Ste 400
Hoover, AL 35242
Phone (423) 238-7568

1025 E West Connector
Ste 406
Austell, GA 30106
Phone (770) 384-1001

1275 Highway 54 W
Ste 200
Fayetteville, GA 30214
Phone (770) 460-8609

7130 Mount Zion Blvd
Ste 9
Jonesboro, GA 30236
Phone (770) 603-5660

400 Tower Rd NE
Ste 140
Marietta, GA 30060
Phone (770) 419-9437

11490 Alpharetta Hwy
Ste 200
Roswell, GA 30076
Phone (770) 740-8592

Organizations & group practices 6

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

NPI Registry JSON

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

{
    "created_epoch": "1577923200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1751241600000",
    "number": "1790324101",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 CORPORATE DR STE 400",
            "city": "HOOVER",
            "state": "AL",
            "postal_code": "352425424"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1275 HIGHWAY 54 W STE 200",
            "city": "FAYETTEVILLE",
            "state": "GA",
            "postal_code": "302144538",
            "telephone_number": "770-460-8609"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARHAM",
        "first_name": "JAKE",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-01-02",
        "last_updated": "2025-06-30",
        "certification_date": "2025-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "GA",
            "license": "OT008793",
            "primary": false
        },
        {
            "code": "225XH1200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Hand",
            "state": "GA",
            "license": "OT008793",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fayetteville, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2025; 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.