Paten Lane Willis, OTR/L

Primary specialty

Pediatric Occupational TherapistTaxonomy code 225XP0200X

License

OT005366 Issued in GA

Practice address

310 Paper Trail Way
Ste 302
Canton, GA 30115-5203

Phone

(770) 345-2804

Fax

(678) 827-0927

NPI assigned

Oct 27, 2011

Last updated

Oct 27, 2011By the provider in NPPES

Sex

Male

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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

• Building Bridges Therapy Inc

  • Speech-Language Pathologist
  • Cumming, GA
  • NPI 1326200452
  NPD (past)
• Grow With Me Pediatric Physical Therapy

  • Physical Therapy Clinic/Center
  • Canton, GA
  • NPI 1134385560
  NPD (past)
• Rising Stars Children's Therapy, Inc

  • Rehabilitation Clinic/Center
  • Woodstock, GA
  • NPI 1104099134

  Pediatrics

  NPD (past)
• Therabeat, Inc.

  • Rehabilitation Clinic/Center
  • Canton, GA
  • NPI 1558500231
  NPD (past)

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

{
    "created_epoch": "1319673600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1319673600000",
    "number": "1831475318",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "310 PAPER TRAIL WAY",
            "address_2": "STE 302",
            "city": "CANTON",
            "state": "GA",
            "postal_code": "301155203",
            "telephone_number": "770-345-2804",
            "fax_number": "678-827-0927"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "310 PAPER TRAIL WAY",
            "address_2": "STE 302",
            "city": "CANTON",
            "state": "GA",
            "postal_code": "301155203",
            "telephone_number": "770-345-2804",
            "fax_number": "678-827-0927"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIS",
        "first_name": "PATEN",
        "middle_name": "LANE",
        "credential": "OTR/L",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-10-27",
        "last_updated": "2011-10-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "GA",
            "license": "OT005366",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Haley Williams
• Taylor Aaliyah Williams
• Teresa Diane Williams, APRN BC
• Karen Lynn Hopkins Williamson, LPN
• Alyssa L.M. Willis, CPNP-PC
• Gregoryia Ebony Willocks
• Heather Wills
• Ashley P Wilson
• Cheney Fenn Wilson, M.D.
• Drew Wilson, MED., LAPC

• Pediatric Occupational Therapist in Canton, GA
• Providers in Canton, GA by specialty
• Pediatric Occupational Therapist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2011; 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.