Nadia Fofana

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

OT005070 Issued in GA

Practice address

747 Overlook Glen Dr
Lawrenceville, GA 30045-3306

Phone

(470) 736-2828

NPI assigned

Jan 5, 2012

Sex

Female

Sole proprietor

No

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1325721600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725321600000",
    "number": "1811267065",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "747 OVERLOOK GLEN DR",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300453306",
            "telephone_number": "470-736-2828"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "747 OVERLOOK GLEN DR",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300453306",
            "telephone_number": "470-736-2828"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3160 Main St",
            "address_purpose": "LOCATION",
            "city": "Duluth",
            "state": "GA",
            "postal_code": "300963460",
            "country_code": "US",
            "telephone_number": "678-404-7744",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1130 Hurricane Shoals Rd NE Ste 2300",
            "address_purpose": "LOCATION",
            "city": "Lawrenceville",
            "state": "GA",
            "postal_code": "300434871",
            "country_code": "US",
            "telephone_number": "470-323-6711",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FOFANA",
        "first_name": "NADIA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-01-05",
        "last_updated": "2024-09-03",
        "certification_date": "2024-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "GA",
            "license": "OT005070",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michael E Flynn, CRNA
• Rebecca O Flynn, CRNA
• FMS Lawrenceville, LLC
• FMS Lawrenceville, LLC
• Focal Caregiving Corporation
• Yuehong Chen Foley, LPC
• Alberta Folk, LCSW
• Cletus Ahidjo Foma, PHARMACIST
• Jeffrey Andrew Forbrick, NP-C
• Bette Ford, MD

• Occupational Therapist in Lawrenceville, GA
• Providers in Lawrenceville, 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 3, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.