Jeniece Davis, COTA/L

Primary specialty

Occupational Therapy AssistantTaxonomy code 224Z00000X

License

OTA002774 Issued in GA

Practice address

11405 Medlock Bridge Rd
Johns Creek, GA 30097-1688

Phone

(770) 814-0505

NPI assigned

Dec 30, 2021

Sex

Female

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

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

{
    "created_epoch": "1640822400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1640822400000",
    "number": "1831850981",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3201 REAGAN WAY",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300443494",
            "telephone_number": "270-991-8503"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11405 MEDLOCK BRIDGE RD",
            "city": "JOHNS CREEK",
            "state": "GA",
            "postal_code": "300971688",
            "telephone_number": "770-814-0505"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "JENIECE",
        "credential": "COTA/L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-12-30",
        "last_updated": "2021-12-30",
        "certification_date": "2021-12-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "GA",
            "license": "OTA002774",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Daniel Eisenman LLC
• Alexandra Ferebee Daniel, PA-C
• Mariah Dantzler
• An Dau, PHARM.D
• Barbara Davis, RPH
• Karen Lee Day-Young
• Samantha Patrice Day, PMHNP
• DCC Optimum Investments, Inc
• Heather Deberry, PA-C
• Decisionpoint LLC

• Occupational Therapy Assistant in Johns Creek, GA
• Providers in Johns Creek, GA by specialty
• Occupational Therapy Assistant in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 2021; 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.