Individual provider Active NPI

Harley Williams, OT R/L

  • Pediatric Occupational Therapist
  • Johnson City, TN
National Provider Identifier
1851973655
Registry record updated Dec 8, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Occupational TherapistTaxonomy code 225XP0200X
License
6808 Issued in TN
Practice address
2214 E Fairview Ave
Johnson City, TN 37601-2860
Phone
(423) 928-6464
NPI assigned
Apr 22, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 8, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Occupational Therapist 225XP0200X 6808 TN Primary

Addresses

Primary practice location

2214 E Fairview Ave
Johnson City, TN 37601-2860

Mailing address

508 Autumn Springs CT
Franklin, TN 37067-8272
Phone (615) 614-8833

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Empowerme Rehabilitation, LLC CurrentSince Sep 20, 2021 Accepting new patients
Empowerme Rehabilitation, LLC CurrentSince Sep 20, 2021 Accepting new patients
Fairview Therapy CurrentSince Dec 10, 2023 Accepting new patients
Mini Miracles Pediatric Therapy, PLLC CurrentSince Dec 10, 2023 Accepting new patients
Star Physical Therapy LP PastSince Apr 1, 2021 Accepting new patients
Ready Set Grow Pediatric Therapy LLC Pediatrics Past Accepting new patients
Pediatric Therapies, Inc PastSince Apr 1, 2021 Accepting new patients

Locations

1335 Strassner Dr
Saint Louis, MO 63144
Phone (314) 673-6723

2214 E Fairview Ave
Johnson City, TN 37601
Phone (423) 928-6464

1020 Charlie Daniels Pkwy
Mt Juliet, TN 37122
Phone (615) 758-4800

Organizations & group practices 7

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": "1619049600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701993600000",
    "number": "1851973655",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "508 AUTUMN SPRINGS CT",
            "city": "FRANKLIN",
            "state": "TN",
            "postal_code": "370678272",
            "telephone_number": "615-614-8833",
            "fax_number": "615-614-8811"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2214 E FAIRVIEW AVE",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376012860",
            "telephone_number": "423-928-6464"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "HARLEY",
        "credential": "OT R/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-04-22",
        "last_updated": "2023-12-08",
        "certification_date": "2023-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "TN",
            "license": "6808",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Johnson City, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 2023; 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.