Marie Myrtha Severe, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

058007 Issued in GA

Practice address

1120 Morningside Drive
Perrry, GA 31088

Phone

(478) 988-1627

NPI assigned

Oct 5, 2006

Last updated

Nov 9, 2009By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other names 1

• Dr. Marie Myrtha Etienne Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Robins Family Medicine

  • Clinic/Center
  • Bonaire, GA
  • NPI 1528238185
  Authorized official Same address or phone
• Adel Emergency Physicians, LLC

  • Emergency Medicine Physician
  • Adel, GA
  • NPI 1124042734
  NPD (past)
• Hospital Authority of Wayne County Georgia

  • Hospitalist Physician
  • Jesup, GA
  • NPI 1275703985
  NPD (past)
• Hospital Authority of Wayne County Georgia

  • Certified Registered Nurse Anesthetist
  • Jesup, GA
  • NPI 1366506222
  NPD (past)
• Peach Emergency Physicians LLC

  • Emergency Medicine Physician
  • Fort Valley, GA
  • NPI 1730348178
  NPD (past)
• Taylor Regional Emergency Physicians, LLC

  • Emergency Medicine Physician
  • Hawkinsville, GA
  • NPI 1225057425
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1160006400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1257724800000",
    "number": "1003902099",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 ARBOR LN",
            "city": "CENTERVILLE",
            "state": "GA",
            "postal_code": "310288606",
            "telephone_number": "478-714-8667",
            "fax_number": "478-225-9720"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1120 MORNINGSIDE DRIVE",
            "city": "PERRRY",
            "state": "GA",
            "postal_code": "31088",
            "telephone_number": "478-988-1627"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SEVERE",
        "first_name": "MARIE",
        "middle_name": "MYRTHA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-05",
        "last_updated": "2009-11-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "GA",
            "license": "058007",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARIE",
            "last_name": "ETIENNE",
            "middle_name": "MYRTHA",
            "prefix": "DR.",
            "credential": "MD",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.