Olivia Tishman, OTD, OTR/L

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

Practice address

1509 Atkinson Rd Ste 2200
Lawrenceville, GA 30043-7986

Phone

(678) 858-4777

Fax

(678) 985-3953

NPI assigned

Jul 20, 2022

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

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1658275200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658275200000",
    "number": "1902531379",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "65 DARCEE CT",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300467402",
            "telephone_number": "678-858-4777",
            "fax_number": "678-985-3953"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1509 ATKINSON RD STE 2200",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300437986",
            "telephone_number": "678-858-4777",
            "fax_number": "678-985-3953"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TISHMAN",
        "first_name": "OLIVIA",
        "credential": "OTD, OTR/L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-07-20",
        "last_updated": "2022-07-20",
        "certification_date": "2022-07-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Ability",
            "affiliation": "N",
            "address_1": "1509 Atkinson Rd Ste 2200",
            "city": "Lawrenceville",
            "state": "GA",
            "country_code": "US",
            "postal_code": "300437986",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Occupational Therapist in Lawrenceville, GA
• Providers in Lawrenceville, GA by specialty
• Occupational Therapist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2022; 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.