Individual provider Active NPI

Lauren E Breck, OTR/L

  • Pediatric Occupational Therapist
  • Dalton, GA
National Provider Identifier
1881979508
Registry record updated Jul 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Occupational TherapistTaxonomy code 225XP0200X
License
OT005352 Issued in GA
Practice address
1201 Burleyson Rd
Dalton, GA 30720-3019
Phone
(706) 876-5000
Fax
(706) 226-8905
NPI assigned
Oct 13, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 26, 2024

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 OT005352 GA Primary

Addresses

Primary practice location

1201 Burleyson Rd
Dalton, GA 30720-3019

Mailing address

1201 Burleyson Rd
Dalton, GA 30720-3019
Phone (706) 876-5000

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
OT005352GAMDPediatric Occupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Hamilton Children'S Institute Inc CurrentSince Jul 28, 2024 Accepting new patients

Organizations & group practices 1

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": "1318464000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721952000000",
    "number": "1881979508",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1201 BURLEYSON RD",
            "city": "DALTON",
            "state": "GA",
            "postal_code": "307203019",
            "telephone_number": "706-876-5000",
            "fax_number": "706-226-8905"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1201 BURLEYSON RD",
            "city": "DALTON",
            "state": "GA",
            "postal_code": "307203019",
            "telephone_number": "706-876-5000",
            "fax_number": "706-226-8905"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRECK",
        "first_name": "LAUREN",
        "middle_name": "E",
        "name_prefix": "Miss",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-10-13",
        "last_updated": "2024-07-26",
        "certification_date": "2024-07-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "GA",
            "license": "OT005352",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dalton, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2024; 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.