Individual provider Active NPI

Elizabeth Leeann Terry, OCCUPATIONAL THERAPI

  • Occupational Therapist
  • Griffin, GA
National Provider Identifier
1912059809
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
OT003395 Issued in GA
Practice address
1428 Hwy 19 41 S
Griffin, GA 30224
Phone
(770) 229-6498
Fax
(770) 229-6958
NPI assigned
Jan 18, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X OT003395 GA Primary

Addresses

Primary practice location

1428 Hwy 19 41 S
Griffin, GA 30224

Mailing address

1428 Hwy 19 41 S
Griffin, GA 30224
Phone (770) 229-6498

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
OT003395GAMDOccupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1169078400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1912059809",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1428 HWY 19 41 S",
            "city": "GRIFFIN",
            "state": "GA",
            "postal_code": "30224",
            "telephone_number": "770-229-6498",
            "fax_number": "770-229-6958"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1428 HWY 19 41 S",
            "city": "GRIFFIN",
            "state": "GA",
            "postal_code": "30224",
            "telephone_number": "770-229-6498",
            "fax_number": "770-229-6958"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TERRY",
        "first_name": "ELIZABETH",
        "middle_name": "LEEANN",
        "credential": "OCCUPATIONAL THERAPI",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-18",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "GA",
            "license": "OT003395",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Griffin, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; 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.