FUNDAMENTAL THERAPY SERVICES, LLC
NPI 1780110155
Occupational Therapist in Clayton, GA

Active since May 04, 2017
165 RIDGECREST CIR, CLAYTON, GA 30525(678) 357-5849 Get Directions Write a Review

NPPES record last updated: October 30, 2023. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Fundamental Therapy Services, Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

FUNDAMENTAL THERAPY SERVICES, LLC (NPI 1780110155) is a healthcare organization registered as an occupational therapist in Clayton, Georgia and active in the NPI registry since May 2017. The organization lists Jennifer Marie Deslich, Owner, as its authorized official.

NPPES Registry Identity

NPI1780110155
Entity TypeOrganization
Primary Taxonomy225X00000X
Legal Business NameFUNDAMENTAL THERAPY SERVICES, LLC
Location Address165 RIDGECREST CIRClayton, GA 30525-4110
Mailing Address4649 E Wolf Creek RdTiger, GA 30576-2946 · (678) 357-5849
Organization SubpartNo
Authorized OfficialJennifer Marie DeslichOwner · (678) 357-5849
Enumeration DateMay 4, 2017
Last NPPES UpdateOctober 30, 2023
NPPES CertifiedOctober 30, 2023
✔ NPI 1780110155 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyOccupational TherapistRespiratory, Developmental, Rehabilitative and Restorative Service Providers
Taxonomy Code225X00000X
Definition
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.
165 RIDGECREST CIR, Clayton, GA 30525

Other Identifiers 1

Medicaid003141022EGA

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Fundamental Therapy Services, Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

4

Medicare enrollment records show 4 clinicians reassign Medicare billing to Fundamental Therapy Services, LLC, which bills Medicare for the services they deliver. Of these, 2 practice at this address. They are listed nearest first.

Clinicians, nearest first (4)

Occupational Therapist in Private Practice
NPI 1790107993
165 RIDGECREST CIR STE B
Clayton, GA 30525
(678) 357-5849
Same address
Qualified Speech Language Pathologist
NPI 1245982289
165 RIDGECREST CIR
Clayton, GA 30525
(678) 357-5849
Same address
Physical Therapist in Private Practice
NPI 1437508439
670 ARRENDALE RD
Dahlonega, GA 30533
(706) 344-9316
46 mi
Occupational Therapist in Private Practice
NPI 1922378736
3985 STEVE REYNOLDS BLVD BLDG G
Norcross, GA 30093
(770) 622-2532
✔ Accepts Medicare77 mi

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Fundamental Therapy Services, LLC's NPI number?

The NPI number for Fundamental Therapy Services, LLC is 1780110155. It was assigned to this organization in the NPPES registry on May 4, 2017.

Where is Fundamental Therapy Services, LLC located?

Fundamental Therapy Services, LLC is located at 165 Ridgecrest Cir, Clayton, GA 30525. The listed phone number is (678) 357-5849.

What is Fundamental Therapy Services, LLC's specialty?

The primary specialty registered for this NPI is Occupational Therapist with taxonomy code 225X00000X.

Is Fundamental Therapy Services, LLC enrolled in Medicare?

Yes. Fundamental Therapy Services, LLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Fundamental Therapy Services, LLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 4 clinicians reassign their Medicare billing to Fundamental Therapy Services, LLC, in Occupational Therapist in Private Practice, Physical Therapist in Private Practice and Qualified Speech Language Pathologist. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Of these, 2 practice at this address. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

When was this NPI record last updated?

The NPPES record for Fundamental Therapy Services, LLC was last updated on October 30, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.