Individual provider Active NPI

Dionne Brunson, O.T.

  • Occupational Therapist
  • Decatur, GA
National Provider Identifier
1841365616
Registry record updated Feb 21, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
OT001419 Issued in GA
Practice address
2385 Lawrenceville Hwy Ste B
Decatur, GA 30033
Phone
(404) 289-4270
NPI assigned
Nov 21, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 21, 2019

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 OT001419 GA Primary

Addresses

Primary practice location

2385 Lawrenceville Hwy Ste B
Decatur, GA 30033

Mailing address

2949 Stonecrest PT
Conyers, GA 30094-4955
Phone (404) 932-3440

Other practice location 1

4310 Johns Creek Pkwy
100
Suwanee, GA 30024-6091
Phone (770) 814-2900

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20201130000067 GA Practitioner - Occupational Therapist in Private Practice 6002227931 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OT001419GAMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Middle Georgia Family Rehab CurrentSince Dec 1, 2020 Accepting new patients
Village Pathways Comprehensive Therapy, LLC Past Accepting new patients

Locations

100 Hamilton Pointe Dr
Ste 115
Byron, GA 31008
Phone (478) 956-4916

4671 Mercer University Dr
Macon, GA 31210
Phone (478) 475-9990

Organizations & group practices 2

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": "1164067200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1550707200000",
    "number": "1841365616",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2949 STONECREST PT",
            "city": "CONYERS",
            "state": "GA",
            "postal_code": "300944955",
            "telephone_number": "404-932-3440",
            "fax_number": "770-483-3955"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2385 LAWRENCEVILLE HWY STE B",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "30033",
            "telephone_number": "404-289-4270"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4310 Johns Creek Pkwy",
            "address_2": "100",
            "address_purpose": "LOCATION",
            "city": "Suwanee",
            "state": "GA",
            "postal_code": "300246091",
            "country_code": "US",
            "telephone_number": "770-814-2900",
            "fax_number": "770-814-7790",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BRUNSON",
        "first_name": "DIONNE",
        "credential": "O.T.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-21",
        "last_updated": "2019-02-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "GA",
            "license": "OT001419",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Decatur, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.