Karen Osbourn Waites, MOT, OTR/L

Primary specialty

Pediatric Occupational TherapistTaxonomy code 225XP0200X

License

OT005047 Issued in GA

Practice address

4212 Coral Park Dr
Brunswick, GA 31520-3016

Phone

(912) 342-8875

Fax

(912) 342-8016

NPI assigned

Jan 30, 2009

Last updated

Nov 6, 2021By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

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.

• Pediatric Therapies of SE Ga, LLC

  • Pediatric Occupational Therapist
  • Brunswick, GA
  • NPI 1841577111

  Pediatrics

  NPD (past)

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

{
    "created_epoch": "1233273600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1636156800000",
    "number": "1851539787",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "136 MARSHS EDGE LN",
            "city": "ST SIMONS ISLAND",
            "state": "GA",
            "postal_code": "315228898",
            "telephone_number": "912-634-4774"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4212 CORAL PARK DR",
            "city": "BRUNSWICK",
            "state": "GA",
            "postal_code": "315203016",
            "telephone_number": "912-342-8875",
            "fax_number": "912-342-8016"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "130 N Gross Rd Ste 125",
            "address_purpose": "LOCATION",
            "city": "Kingsland",
            "state": "GA",
            "postal_code": "315486263",
            "country_code": "US",
            "telephone_number": "912-342-8875",
            "fax_number": "912-342-8016",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WAITES",
        "first_name": "KAREN",
        "middle_name": "OSBOURN",
        "name_prefix": "Mrs.",
        "credential": "MOT, OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-01-30",
        "last_updated": "2021-11-06",
        "certification_date": "2021-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "GA",
            "license": "OT005047",
            "primary": true
        },
        {
            "code": "225XG0600X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Gerontology",
            "state": "GA",
            "license": "OT005047",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Laura Hayley Veal, FNP
• Vision Center of Brunswick, Inc (Vision Center of Brunsiwck)
• Vitas Laboratory LLC
• Kelly Danielle Wagner, PTA
• Emma Wainright, BCBA
• Wal-Mart Stores East LP (Walmart Pharmacy 10-2840)
• Wal-Mart Stores East LP (Walmart Pharmacy 10-0639)
• Wal-Mart Stores East, LP. (Walmart pharmacy 10-3164)
• Kristine Waldron, RN
• Walgreen Co (Walgreens #10266)

• Pediatric Occupational Therapist in Brunswick, GA
• Providers in Brunswick, 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 Nov 6, 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.