Basic Information
Provider Information
NPI: 1417084609
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: ATKINS
FirstName: TAMI
MiddleName: S.
NamePrefix: MRS.
NameSuffix:  
Credential: O.T.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1829 E FRANKLIN ST
Address2: BLDG. # 600
City: CHAPEL HILL
State: NC
PostalCode: 275145861
CountryCode: US
TelephoneNumber: 9199683456
FaxNumber: 9199323456
Practice Location
Address1: 1829 E FRANKLIN ST
Address2: BLDG. # 600
City: CHAPEL HILL
State: NC
PostalCode: 275145861
CountryCode: US
TelephoneNumber: 9199683456
FaxNumber: 9199323456
Other Information
ProviderEnumerationDate: 02/27/2007
LastUpdateDate: 07/09/2007
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
225XP0200X6051NCY Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics

ID Information
IDTypeStateIssuerDescription
730192605NC MEDICAID
1418C01NCBLUE CROSSOTHER


Home