HAROLD GOODRUM JR. (NPI# 1194273185) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1194273185 |
| Entity Type | Individual |
| Full Name | HAROLD GOODRUM JR. |
| Practice Address |
575 Dekalb Industrial Way Suite 103 Decatur GA 30030-1756 |
| Practice Telephone | 4042968511 |
| Practice Fax Number | 4042968514 |
| Mailing Telephone | 4042968511 |
| Mailing Fax Number | 4042968514 |
| Enumeration Date | 2016-09-19 |
| Last Update Date | 2016-09-19 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 225X00000X | Occupational Therapist | 002554 | GA | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| GA | OT LICENSE | 002554 | 01 |
| Street Address |
575 DEKALB INDUSTRIAL WAY SUITE 103 |
| City | DECATUR |
| State | GA |
| Zip Code | 30030-1756 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972589406 | Complete Home Medical Equipment, Inc | Durable Medical Equipment & Medical Supplies | 575 Dekalb Industrial Way, Decatur, GA 30033-1756 | 2005-12-16 |
| 1437695723 | Emily Lloyd | Physical Therapist | 575 Dekalb Industrial Way, Suite 103, Decatur, GA 30030-1756 | 2017-01-11 |
| 1568894434 | Mira Abdurashid Ahmed | Chiropractor | 575 Dekalb Industrial Way, Ste 105, Decatur, GA 30030-1756 | 2013-08-02 |
| 1972763910 | Helen Berg Walsh | Physical Therapist | 575 Dekalb Industrial Way, Suite 103, Decatur, GA 30030-1756 | 2008-06-12 |
| 1174782502 | Serena Lund Van Eeuwen | Physical Therapist | 575 Dekalb Industrial Way, Suite 103, Decatur, GA 30030-1756 | 2008-06-02 |
| 1386812899 | Beth Margaret Birmingham | Occupational Therapist | 575 Dekalb Industrial Way, Suite 103, Decatur, GA 30030-1756 | 2008-02-19 |
| 1851506448 | Decatur Hand Therapy Specialists Limited Partnership | Durable Medical Equipment & Medical Supplies | 575 Dekalb Industrial Way, Suite 103, Decatur, GA 30030-1756 | 2007-05-14 |
| 1962556910 | Laura Lee Higgins | Physical Therapist | 575 Dekalb Industrial Way, Suite 103, Decatur, GA 30030-1756 | 2007-01-23 |
| 1457429011 | Amanda Z. Jackson | Occupational Therapist | 575 Dekalb Industrial Way, Suite 103, Decatur, GA 30030-1756 | 2006-12-01 |
| 1932166782 | Rachele Pighin Branson | Occupational Therapist | 575 Dekalb Industrial Way, Suite 103, Decatur, GA 30033 | 2006-04-26 |
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| 1801413174 | Pa-c Surgical Assist, LLC | Clinic/Center | 520 W Ponce Leon Ave #1706, Decatur, GA 30030 | 2020-07-02 |
| 1417587478 | Elizabeth Heffron | Acupuncturist | 619b East College Avenue, Decatur, GA 30030 | 2020-01-17 |
| 1669016143 | Atlanta Upper Cervical Chiropractic LLC | Chiropractor | 125 E Trinity Place, Suite #247, Decatur, GA 30030 | 2019-10-29 |
| 1831757418 | Jessica Stewart | Counselor | 755 Commerce Dr Ste 903, Decatur, GA 30030 | 2019-05-30 |
| 1699238733 | Dinah Augustin | Registered Nurse | 1458 Church St., Unit B, Decatur, GA 30030 | 2019-04-06 |
| 1093284291 | Eliza Segell | Social Worker | 165 Dekalb Industrial Way Ste D-1, Decatur, GA 30030 | 2018-11-16 |
| 1912476466 | Positive Impact Health Centers, Inc. | Pharmacy | 523 Church Street, Suite B, Decatur, GA 30030 | 2018-11-14 |
| 1932685096 | T2 Imaging | Radiology | 1376 Church Street, Suite 100, Decatur, GA 30030 | 2018-07-12 |
| 1992292858 | Keeanna M Powell | Counselor | Agape Transformation Practice, 235 E. Ponce De Leon Ave Suite 103, Decatur, GA 30030 | 2018-04-17 |
| 1780185488 | Solutions Ae Inc | Counselor | One West Square Court, Suite 710, Decatur, GA 30030 | 2018-02-27 |
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| Taxonomy Code | 225X00000X |
| Grouping | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Classification | Occupational Therapist |
| An occupational therapist is a person who has graduated from an entry-level occupational therapy program accredited by the Accreditation Council for Occupational Therapy Education (ACOTE) or predecessor organizations, or approved by the World Federation of Occupational Therapists (WFOT), or an equivalent international occupational therapy education program; has successfully completed a period of supervised fieldwork experience required by the occupational therapy program; has passed a nationally recognized entry-level examination for occupational therapists, and fulfills state requirements for licensure, certification, or registration. An occupational therapist provides interventions based on evaluation and which emphasize the therapeutic use of everyday life activities (i.e., occupations) with individuals or groups for the purpose of facilitating participation in roles and situations and in home, school, workplace, community and other settings. Occupational therapy services are provided for the purpose of promoting health and wellness and are provided to those who have or are at risk for developing an illness, injury, disease, disorder, condition, impairment, disability, activity limitation, or participation restriction. Occupational therapists address the physical, cognitive, psychosocial, sensory, and other aspects of occupational performance in a variety of contexts to support engagement in everyday life activities that affect health, well-being, and quality of life. |
| Notes: Source: The Guide to Occupational Therapy Practice, 2nd edition. Bethesda: American Occupational Therapy Association, 2007. [7/1/2008: definition changed, added source] |
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| 1396381554 | Justin Nelson | Occupational Therapist | 1415 W Mound Rd, Decatur, IL 62526-1263 | 2019-11-22 |
| 1689132342 | Arvin Quicho | Occupational Therapist | 3911 E Camelot Cir Apt 102, Decatur, IL 62526-6917 | 2019-03-12 |
| 1700381159 | Aegis Group Practice LLC | Occupational Therapist | 218 E Trinity Pl Ste A, Decatur, GA 30030-3410 | 2018-03-28 |
| 1356841332 | Rebecca Marie Davis | Occupational Therapist | 251 Johnston St Se Ste 200, Decatur, AL 35601-2515 | 2018-02-16 |
| 1366961765 | Maria O'farrell | Occupational Therapist | 495 Winn Way Ste 210, Decatur, GA 30030-1710 | 2017-09-18 |
| 1164962437 | Kristen Julian | Occupational Therapist | 341 Winn Way, Decatur, GA 30030-2120 | 2017-03-06 |
| 1396292025 | Africa Mincey | Occupational Therapist | 711 Twin Oaks Dr, Apartment 3, Decatur, GA 30030-4001 | 2016-09-11 |
| 1184096000 | Sarah Ingrid Stromsdorfer | Occupational Therapist | 460 Medlock Rd, Decatur, GA 30030-1508 | 2015-10-30 |
| 1730556655 | Johnaca Templeton | Occupational Therapist | 3088 Centerpoint Rd, Decatur, TN 37322-4631 | 2015-08-26 |
| 1528441185 | Jonathan Bullen | Occupational Therapist | 425 Winn Way, Decatur, GA 30030-1732 | 2015-07-01 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.