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MOON RIVER LLC NPI 1730143553


NPI Information

NPI: 1730143553
Provider Name: MOON RIVER, LLC
Classification: Occupational Therapist - 225XP0200X
Entity Type: Organization

Specialization: Pediatrics

Address:
790 OAK TRAIL DR
MARIETTA, GA
ZIP 30062
Phone: (770) 977-6866
Get Directions

MOON RIVER, LLC is a pediatrics occupational therapist in Marietta, GA. The provider is occupational therapists provide services to infants, toddlers and children who have or who are at risk for developmental delays or disabilities. Occupational therapy is concerned with a child's ability to participate in daily life activities or occupations. Occupational therapists use their unique expertise to help children with social-emotional, physical, cognitive, communication, and adaptive behavioral challenges and to help children to be prepared for and perform important learning and school-related activities and to fulfill their rule as students. Through an understanding of the impact of disability, illness, and impairment on a child's development, plan, ability to learn new skills, and overall occupational performance, occupational therapists design interventions that promote healthy development, establish needed skills, and/or modify environments, all in support of participation in daily activities. MOON RIVER, LLC NPI is 1730143553. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

790 OAK TRAIL DR
MARIETTA, GA
ZIP 30062-502
Phone: (770) 977-6866
Fax: (770) 977-6887

The provider's authorized official is Maria Teresa Smith .
The authorized official title is Office Administrator and has the following contact phone number (770) 977-6866.

The enumeration date for this NPI number is 4/17/2006 and was last updated on 2/15/2017.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1225100000XPhysical TherapistPT003833GEORGIANo
2225100000XPhysical TherapistPT008523GEORGIANo
3225100000XPhysical TherapistPT008507GEORGIANo
4225100000XPhysical TherapistPT001355GEORGIANo
5225100000XPhysical TherapistPT007864GEORGIANo
6225100000XPhysical TherapistPT005771GEORGIANo
7225100000XPhysical TherapistPT008924GEORGIANo
8225XP0200XOccupational TherapistPediatricsGAOT001717GEORGIAYes
9225X00000XOccupational TherapistOT004577GEORGIANo
10225XP0200XOccupational TherapistPediatricsOT 004293GEORGIANo
11235Z00000XSpeech-Language PathologistSLP003992GEORGIANo
12235Z00000XSpeech-Language PathologistSLP005806GEORGIANo
13235Z00000XSpeech-Language PathologistSLP006528GEORGIANo
14235Z00000XSpeech-Language PathologistSLP 006556GEORGIANo
15235Z00000XSpeech-Language PathologistSLP 06551GEORGIANo

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1000753563EMEDICAIDGEORGIA
2146855825AMEDICAIDGEORGIA
3317872221AMEDICAIDGEORGIA
4426315361AMEDICAIDGEORGIA
5765677599AMEDICAIDGEORGIA
6986209149BMEDICAIDGEORGIA
7191707573AMEDICAIDGEORGIA
8761415888AMEDICAIDGEORGIA
9240960806AMEDICAIDGEORGIA
10000860736BMEDICAIDGEORGIA
11516643175AMEDICAIDGEORGIA
12315889908AMEDICAIDGEORGIA
13461168837AMEDICAIDGEORGIA
14850524466AMEDICAIDGEORGIA
15000970835AMEDICAIDGEORGIA
16339518223AMEDICAIDGEORGIA
17188883028BMEDICAIDGEORGIA
18481436178BMEDICAIDGEORGIA
19503885675BMEDICAIDGEORGIA
20814363142AMEDICAIDGEORGIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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