James Walker Penland Jr., COTA/L

Primary specialty

Occupational Therapy AssistantTaxonomy code 224Z00000X

License

001090 Issued in GA

Practice address

2414 Camelot Dr
Augusta, GA 30904-3327

Phone

(706) 736-0867

NPI assigned

Dec 22, 2009

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1261440000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1261440000000",
    "number": "1962731950",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2414 CAMELOT DR",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309043327",
            "telephone_number": "706-736-0867"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2414 CAMELOT DR",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309043327",
            "telephone_number": "706-736-0867"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PENLAND",
        "first_name": "JAMES",
        "middle_name": "WALKER",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "credential": "COTA/L",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-12-22",
        "last_updated": "2009-12-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "GA",
            "license": "001090",
            "primary": true
        },
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "VA",
            "license": "0131000520",
            "primary": false
        },
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "SC",
            "license": "2772",
            "primary": false
        },
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "TN",
            "license": "1785",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michael Phillip Pence, D.O.
• Lilian Pencille, LCSW
• Robert Pendergrast Jr., MD
• Brooks Edward Pendleton, PT, DPT
• Pendley Personal Care Home Inc.
• Penn Heart LLC
• Penn Teck Diagnostics Inc
• Jaime Penn
• Clayton William Pennington, M.D.
• Weems R Pennington Jr., MD

• Occupational Therapy Assistant in Augusta, GA
• Providers in Augusta, GA by specialty
• Occupational Therapy Assistant in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 22, 2009; 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.