Individual provider Active NPI

Madison Jones, OTR/L

  • Occupational Therapist
  • Dacula, GA
National Provider Identifier
1962045005
Registry record updated Oct 22, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
OT007555 Issued in GA
Practice address
2089 Teron Trce Ste 120
Dacula, GA 30019-1609
Phone
(770) 904-6009
NPI assigned
Oct 22, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 22, 2019

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 OT007555 GA Primary

Addresses

Primary practice location

2089 Teron Trce Ste 120
Dacula, GA 30019-1609

Mailing address

2089 Teron Trce Ste 120
Dacula, GA 30019-1609
Phone (770) 904-6009

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 2019
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

102 Oakwood Hills Dr
Suwanee, GA 30024-1773

1854 Auburn Rd
Suite 101
Dacula, GA 30019-1130

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OT007555GAMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Tender Ones Therapy Services, Inc. CurrentSince Oct 27, 2019 Accepting new patients
Teamup Therapy LLC Occupational Therapist Past Accepting new patients

Locations

2089 Teron Trce
Ste 120
Dacula, GA 30019
Phone (770) 904-2357

1100 Sherwood Park Dr NE
Ste 220
Gainesville, GA 30501
Phone (678) 971-5048

Organizations & group practices 2

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": "1571702400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1571702400000",
    "number": "1962045005",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2089 TERON TRCE STE 120",
            "city": "DACULA",
            "state": "GA",
            "postal_code": "300191609",
            "telephone_number": "770-904-6009"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2089 TERON TRCE STE 120",
            "city": "DACULA",
            "state": "GA",
            "postal_code": "300191609",
            "telephone_number": "770-904-6009"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JONES",
        "first_name": "MADISON",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-10-22",
        "last_updated": "2019-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "GA",
            "license": "OT007555",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dacula, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.