Individual provider Active NPI

Mariam McCauley

  • Occupational Therapist
  • Southaven, MS
National Provider Identifier
1942084686
Registry record updated Aug 23, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
2956 Issued in MS
Practice address
3521 Enclave Dr
Southaven, MS 38672-7051
Phone
(901) 828-8297
NPI assigned
Aug 23, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 23, 2023

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 2956 MS Primary

Addresses

Primary practice location

3521 Enclave Dr
Southaven, MS 38672-7051

Mailing address

3521 Enclave Dr
Southaven, MS 38672-7051
Phone (901) 828-8297

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

State licenses

LicenseStateTypeSpecialty
2956MSMDOccupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1692748800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692748800000",
    "number": "1942084686",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3521 ENCLAVE DR",
            "city": "SOUTHAVEN",
            "state": "MS",
            "postal_code": "386727051",
            "telephone_number": "901-828-8297"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3521 ENCLAVE DR",
            "city": "SOUTHAVEN",
            "state": "MS",
            "postal_code": "386727051",
            "telephone_number": "901-828-8297"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCAULEY",
        "first_name": "MARIAM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-08-23",
        "last_updated": "2023-08-23",
        "certification_date": "2023-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "MS",
            "license": "2956",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Southaven, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 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.