Protherapy Inc

Primary specialty

Pediatric Occupational TherapistTaxonomy code 225XP0200X

License

OT003698 Issued in GA

Legal business name

PROTHERAPY INC

Practice address

976 Redstone Rd
Dacula, GA 30019-7415

Phone

(770) 995-2345

Fax

(678) 392-4401

NPI assigned

Nov 11, 2006

Organization subpart

No

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

Authorized official

Name

Mrs. Helena Jordan, OTR

Title

President

Phone

(770) 277-3945

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1163203200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1902977192",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "976 REDSTONE RD",
            "city": "DACULA",
            "state": "GA",
            "postal_code": "300197415",
            "telephone_number": "770-995-2345",
            "fax_number": "678-392-4401"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "976 REDSTONE RD",
            "city": "DACULA",
            "state": "GA",
            "postal_code": "300197415",
            "telephone_number": "770-995-2345",
            "fax_number": "678-392-4401"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROTHERAPY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-11",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "JORDAN",
        "authorized_official_first_name": "HELENA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "770-277-3945",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "OTR"
    },
    "taxonomies": [
        {
            "code": "225XP0200X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "GA",
            "license": "OT003698",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Pediatric Occupational Therapist in Dacula, GA
• Providers in Dacula, 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 Aug 22, 2020; 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.