Individual provider Active NPI

Mia Elsabie Van Schalkwyk, OTR/L

  • Occupational Therapist
  • Atlanta, GA
National Provider Identifier
1831783182
Registry record updated Feb 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
OT007966 Issued in GA
Practice address
739 W Peachtree St NE
Atlanta, GA 30308-1137
Phone
(404) 875-9011
NPI assigned
Feb 26, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 16, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X OT007966 GA Primary

Addresses

Primary practice location

739 W Peachtree St NE
Atlanta, GA 30308-1137

Mailing address

3071 Randolph Rd NE
Atlanta, GA 30345-3612
Phone (734) 756-0868

Other practice location 1

3071 Randolph Rd NE
Atlanta, GA 30345-3612
Phone (734) 756-0868

Other names 1

  • Mia Vermaak Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240305000786 GA Practitioner - Occupational Therapist in Private Practice 8729423330 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Center for the Visually ImpairedGroup PAC ID 8527009034, 9 clinicians

Practice addresses (Care Compare)

739 W Peachtree St NW
Atlanta, GA 30308-1137
Phone (404) 875-9011

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OT007966GAMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Center for the Visually Impaired CurrentSince Jan 21, 2024 Accepting new patients
The George Center Foundation PastSince Mar 1, 2021 Accepting new patients
Cobblestone Pathways, LLC PastSince Mar 1, 2021 Accepting new patients

Locations

739 W Peachtree St NE
Atlanta, GA 30308
Phone (404) 875-9011

1488 Jesse Jewell Pkwy SE
Ste 200
Gainesville, GA 30501
Phone (404) 875-9011

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1614297600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708041600000",
    "number": "1831783182",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3071 RANDOLPH RD NE",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303453612",
            "telephone_number": "734-756-0868"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "739 W PEACHTREE ST NE",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303081137",
            "telephone_number": "404-875-9011"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3071 Randolph Rd NE",
            "address_purpose": "LOCATION",
            "city": "Atlanta",
            "state": "GA",
            "postal_code": "303453612",
            "country_code": "US",
            "telephone_number": "734-756-0868",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VAN SCHALKWYK",
        "first_name": "MIA",
        "middle_name": "ELSABIE",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-02-26",
        "last_updated": "2024-02-16",
        "certification_date": "2024-02-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "GA",
            "license": "OT007966",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MIA",
            "last_name": "VERMAAK",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Atlanta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 2024; 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.