Individual provider Active NPI

Katelyn Loraine Mulroney

  • Occupational Therapy Assistant
  • Athens, GA
National Provider Identifier
1821639618
Registry record updated Oct 2, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Therapy AssistantTaxonomy code 224Z00000X
License
OTA001080 Issued in GA
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

Updated by the provider on Oct 2, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
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

LicenseStateTypeSpecialty
OTA001080GAMDOccupational 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.

Verify at the official NPI Registry.