Mitzie Marion Colet Mickelson, OTR/L, CPAM

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

OT004641 Issued in GA

Practice address

511 W 10TH St NE
Rome, GA 30165-2652

Phone

(706) 235-0807

NPI assigned

Aug 20, 2020

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

Specialty

Occupational Therapist in Private Practice

Education

Other, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

The Weston Group IncGroup PAC ID 8123936796, 215 clinicians

Paxxon Healthcare Services LLCGroup PAC ID 8325959554, 153 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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 and National Provider Directory roles.

• Paxxon Healthcare Services LLC

  • Physical Therapist
  • Alpharetta, GA
  • NPI 1386917532

  Single Specialty

  Medicare reassignment Care Compare group NPD
• The Weston Group Inc.

  • Physical Therapist
  • Acworth, GA
  • NPI 1841309101

  Single Specialty

  Medicare reassignment Care Compare group NPD
• Empowerme Rehabilitation Georgia, LLC

  • Multi-Specialty Clinic/Center
  • Cumming, GA
  • NPI 1952934374

  Occupational Therapist

  Medicare reassignment NPD
• Legacy Healthcare Services, Inc.

  • Physical Therapist
  • Dawsonville, GA
  • NPI 1528419751

  Occupational Therapist

  Medicare reassignment NPD
• Horizons Therapy Group, Inc.

  • Physical Therapist
  • Cedartown, GA
  • NPI 1720373020

  Single Specialty

  NPD
• Legacy Healthcare Services Inc

  • Physical Therapist
  • Cary, NC
  • NPI 1225879489

  Occupational Therapist

  NPD
• Paxxon Healthcare Services LLC

  • Physical Therapist
  • Colorado Springs, CO
  • NPI 1336808146

  Single Specialty

  NPD
• The Weston Group Inc.

  • Physical Therapist
  • Easton, PA
  • NPI 1750250759
  NPD

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

{
    "created_epoch": "1597881600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597881600000",
    "number": "1801408802",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1501 SUMMER GATE WAY APT 12",
            "city": "DALTON",
            "state": "GA",
            "postal_code": "307205385",
            "telephone_number": "408-218-4635"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "511 W 10TH ST NE",
            "city": "ROME",
            "state": "GA",
            "postal_code": "301652652",
            "telephone_number": "706-235-0807"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MICKELSON",
        "first_name": "MITZIE MARION",
        "middle_name": "COLET",
        "name_prefix": "Mrs.",
        "credential": "OTR/L, CPAM",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-08-20",
        "last_updated": "2020-08-20",
        "certification_date": "2020-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Occupational Therapist",
            "state": "GA",
            "license": "OT004641",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2020; 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.