Artem Djouraev

Primary specialty

Pediatric Occupational TherapistTaxonomy code 225XP0200X

License

OT006857 Issued in GA

Practice address

1456 McLendon Dr Ste B
Decatur, GA 30033-1848

Phone

(404) 728-9766

NPI assigned

Nov 14, 2017

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Mr. Artem Djouraev Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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

• Associated Therapies, Inc

  • Early Intervention Provider Agency
  • Decatur, GA
  • NPI 1972772143
  NPD (past)

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

{
    "created_epoch": "1510617600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1510617600000",
    "number": "1356854129",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1318 CAROLYN DR NE",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303293547",
            "telephone_number": "678-860-3245"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1456 MCLENDON DR STE B",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "300331848",
            "telephone_number": "404-728-9766"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DJOURAEV",
        "first_name": "ARTEM",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-11-14",
        "last_updated": "2017-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "GA",
            "license": "OT006857",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ARTEM",
            "last_name": "DJOURAEV",
            "prefix": "MR.",
            "credential": "OTR/L",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Cecelia Dixie, M.S.W. - LCSW
• Andrew Alexander Dixon, M.D.
• Anna Dixon, MCD, CCC-SLP
• Kevin Dixon
• Marla Lynn Dixon
• Kevin Oshiro DO, MD
• Trinh Phuong Doan, DPM
• Kim Melissa Dobson-Callahan, M.D.
• Holly M Dobson, MS, RD, LD
• Chandrea Dock

• Pediatric Occupational Therapist in Decatur, GA
• Providers in Decatur, GA by specialty
• Pediatric Occupational Therapist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2017; 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.