LAURA SUPPA (NPI# 1962744326) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1962744326 |
| Entity Type | Individual |
| Full Name | LAURA SUPPA |
| Credential | OT |
| Practice Address |
536 Grand Slam Dr Suite D Evans GA 30809-8044 |
| Practice Telephone | 7068548434 |
| Practice Fax Number | 7068548435 |
| Mailing Telephone | 7068548434 |
| Mailing Fax Number | 7068548435 |
| Enumeration Date | 2013-03-25 |
| Last Update Date | 2013-03-25 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 225X00000X | Occupational Therapist | OT005650 | GA | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235571563 | Laura Marie Suppa | Optometrist | 4202 Maccorkle Ave Se, Charleston, WV 25304-2502 | 2013-07-29 |
| Street Address |
536 GRAND SLAM DR SUITE D |
| City | EVANS |
| State | GA |
| Zip Code | 30809-8044 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679649008 | Samantha Allison Stahl | Physical Therapist | 536 Grand Slam Dr, Evans, GA 30809-8014 | 2006-11-28 |
| 1609336288 | Victoria Carnell | Occupational Therapist | 536 Grand Slam Dr, Evans, GA 30809-8044 | 2019-03-21 |
| 1841741576 | Kellie Brewer | Occupational Therapist | 536 Grand Slam Dr, Evans, GA 30809-8044 | 2016-10-18 |
| 1235510918 | Ronda Long | Occupational Therapy Assistant | 536 Grand Slam Dr, Evans, GA 30809-8044 | 2015-06-17 |
| 1376942508 | Elizabeth Peavy | Speech-Language Pathologist | 536 Grand Slam Dr, Evans, GA 30809-8044 | 2014-08-13 |
| 1932531209 | Stephen Tyler Shultz | Physical Therapist | 536 Grand Slam Dr, Suite D, Evans, GA 30809-8044 | 2013-08-08 |
| 1265775605 | Sherry Brown | Occupational Therapist | 536 Grand Slam Dr, Suite D, Evans, GA 30809-8044 | 2013-04-04 |
| 1700123163 | Allison Carol Boggs | Speech-Language Pathologist | 536 Grand Slam Dr, Suite D, Evans, GA 30809-8044 | 2013-01-05 |
| 1912250382 | Krista Odom | Occupational Therapist | 536 Grand Slam Dr, Evans, GA 30809-8044 | 2012-10-22 |
| 1629396312 | Dana Stevenson | Speech-Language Pathologist | 536 Grand Slam Dr, Evans, GA 30809-8044 | 2010-05-05 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326674060 | Dominion Behavioral Health Services LLC | Psychiatric Unit | 817 Prairie Lane, Evans, GEORGIA 30809 | 2020-03-13 |
| 1710478102 | Georgia Dental Professionals, PC | Dentist | 5131 Washington Rd, Evans, GA 30809 | 2018-05-22 |
| 1649770678 | Angel Legare | Physician Assistant | 404 Town Park Blvd Ste 101, Evans, GA 30809 | 2018-02-16 |
| 1952829541 | Felicia Evette Rhodes | Home Health Aide | 715 Jones Creek, Evans, GA 30809 | 2017-09-02 |
| 1659733582 | Patricia J. Stewart Lpc, LLC | Counselor | 465 N. Belair Rd. Ste 2d, Evans, GA 30809 | 2016-03-21 |
| 1114306727 | John Mccaskey | Family Medicine | 465 N Belair Rd Ste 1b, Evans, GA 30809 | 2015-05-28 |
| 1053702878 | Jennifer Wahl | Assistant Behavior Analyst | 1135 Waltons Pass, Evans, GA 30809 | 2015-02-16 |
| 1609298777 | Custom Pharmacy, Inc | Pharmacy | 1202 Town Park Lane, Suite 200, Evans, GA 30809 | 2014-01-09 |
| 1457797938 | Perfect Health Always On Call, LLC | Non-Pharmacy Dispensing Site | 4244 Washington Rd, Evans, GA 30809 | 2013-05-11 |
| 1417207119 | Tommy Battle | Respiratory Therapist, Registered | 101 Pond View, Evans, GA 30809 | 2012-09-11 |
| Find all providers in zip 30809 | ||||
| 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] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861008880 | India Shae Hawk | Occupational Therapist | 616 Millstone Dr, Evans, GA 30809-5173 | 2020-09-16 |
| 1790293231 | Independent Physical Therapy of Ga LLC | Occupational Therapist | 4446 Washington Rd Ste 8, Evans, GA 30809-6361 | 2018-01-18 |
| 1386187193 | Caactus Flowers Rock Stars LLC | Occupational Therapist | 4455 Washington Rd, Evans, GA 30809-6326 | 2016-11-28 |
| 1902260789 | Regina Frazier | Occupational Therapist | 818 Prairie Ln, Evans, GA 30809-4263 | 2016-04-07 |
| 1669847794 | Sharon Swift | Occupational Therapist | 1250 Hardy Pointe Dr, Evans, GA 30809-5281 | 2015-12-01 |
| 1124267646 | Lillian Nicole Brewer | Occupational Therapist | 4130 Fox Brush Dr, Evans, GA 30809-4856 | 2009-02-05 |
| 1699965954 | Christina Lynn Rocker Merchant | Occupational Therapist | 568 Blue Ridge Drive, Evans, GA 30809 | 2007-08-01 |
| 1740489871 | Maureen Mcdonnell | Occupational Therapist | 3512 Greenway Dr, Evans, GA 30809-4277 | 2007-07-18 |
| 1205998069 | Melissa W Fitzgerald | Occupational Therapist | 446 Northridge Cir, Evans, GA 30809-4542 | 2006-12-15 |
| 1295822187 | Nancy Lynn Clements-morgan | Occupational Therapist | 5086 Wells Dr, Evans, GA 30809-7036 | 2006-10-10 |
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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.