Active NPI
Katelyn Loraine Mulroney
- Occupational Therapy Assistant
- Athens, GA
National Provider Identifier
1821639618
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapy Assistant
- License
- OTA001080
- Practice address
- 755 Epps Bridge Pkwy
Athens, GA 30606-6987 - Phone
- (706) 995-7177
- NPI assigned
- Oct 2, 2019
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapy Assistant | 224Z00000X | OTA001080 | GA | Primary |
Addresses
Primary practice location
755 Epps Bridge Pkwy
Athens, GA 30606-6987
Mailing address
2717 Powell CT
Monroe, GA 30656-8676
Phone (706) 248-5323
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| OTA001080 | GA | MD | Occupational Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1569974400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1569974400000",
"number": "1821639618",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2717 POWELL CT",
"city": "MONROE",
"state": "GA",
"postal_code": "306568676",
"telephone_number": "706-248-5323"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "755 EPPS BRIDGE PKWY",
"city": "ATHENS",
"state": "GA",
"postal_code": "306066987",
"telephone_number": "706-995-7177"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MULRONEY",
"first_name": "KATELYN",
"middle_name": "LORAINE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-10-02",
"last_updated": "2019-10-02",
"status": "A"
},
"taxonomies": [
{
"code": "224Z00000X",
"taxonomy_group": "",
"desc": "Occupational Therapy Assistant",
"state": "GA",
"license": "OTA001080",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Athens, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.