Suzetta Rogers Brazile, OTR/L

Primary specialty

Gerontology Occupational TherapistTaxonomy code 225XG0600X

License

02440 Issued in NE

Practice address

91 Barrington Farms Pkwy
Sharpsburg, GA 30277-1853

Phone

(404) 667-5158

Fax

(404) 667-5158

NPI assigned

Aug 13, 2013

Last updated

Aug 13, 2013By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1376352000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1376352000000",
    "number": "1346673464",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "91 BARRINGTON FARMS PKWY",
            "city": "SHARPSBURG",
            "state": "GA",
            "postal_code": "302771853",
            "telephone_number": "404-667-5158",
            "fax_number": "404-667-5158"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "91 BARRINGTON FARMS PKWY",
            "city": "SHARPSBURG",
            "state": "GA",
            "postal_code": "302771853",
            "telephone_number": "404-667-5158",
            "fax_number": "404-667-5158"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRAZILE",
        "first_name": "SUZETTA",
        "middle_name": "ROGERS",
        "name_prefix": "Mrs.",
        "credential": "OTR/L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-08-13",
        "last_updated": "2013-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NE",
            "license": "02440",
            "primary": false
        },
        {
            "code": "225XG0600X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Gerontology",
            "state": "NE",
            "license": "02440",
            "primary": true
        },
        {
            "code": "225XM0800X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Mental Health",
            "state": "NE",
            "license": "02440",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Gerontology Occupational Therapist in Sharpsburg, GA
• Providers in Sharpsburg, GA by specialty
• Gerontology Occupational Therapist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2013; 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.