Ebony White Peterman, OTR/L, CLT

Primary specialty

Physical Rehabilitation Occupational TherapistTaxonomy code 225XP0019X

License

0119004514 Issued in VA

Practice address

241 McLaws Cir Ste 105
Williamsburg, VA 23185-5861

Phone

(757) 503-9665

NPI assigned

Nov 21, 2022

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1668988800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1668988800000",
    "number": "1306555073",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10512 TEA OLIVE CIR",
            "city": "PROVIDENCE FORGE",
            "state": "VA",
            "postal_code": "231404528",
            "telephone_number": "804-687-3140"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "241 MCLAWS CIR STE 105",
            "city": "WILLIAMSBURG",
            "state": "VA",
            "postal_code": "231855861",
            "telephone_number": "757-503-9665"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10512 Tea Olive Cir",
            "address_purpose": "LOCATION",
            "city": "Providence Forge",
            "state": "VA",
            "postal_code": "231404528",
            "country_code": "US",
            "telephone_number": "804-687-3140",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PETERMAN",
        "first_name": "EBONY",
        "middle_name": "WHITE",
        "credential": "OTR/L, CLT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-11-21",
        "last_updated": "2022-11-21",
        "certification_date": "2022-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XP0019X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Occupational Therapist, Physical Rehabilitation",
            "state": "VA",
            "license": "0119004514",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VIRGINIA LICENSE",
            "identifier": "0119004514",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lorraine K. Perkins, NP
• Tara Lee Perkins, DPT
• Naeemah Perriott
• Ryan Seth Perry, MD
• Personal Touch Home Aides of VA, Inc.
• Samantha Nicole Peters
• Brent C Peterson, PH.D, LPC, ATR,
• Stephanie Denise Peterson, LPC
• Britney Phillips, L.M.T
• Zaw Win Phyo, M.B,B.S

• Physical Rehabilitation Occupational Therapist in Williamsburg, VA
• Providers in Williamsburg, VA by specialty
• Physical Rehabilitation Occupational Therapist in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2022; 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.