Kimbra Suzanne Edge, OTR/L

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

OT002070 Issued in GA

Practice address

11190 Medlock Bridge Rd
Duluth, GA 30097-2578

Phone

(678) 849-5847

NPI assigned

Apr 23, 2012

Last updated

Feb 7, 2020By 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 1

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

Specialty

Occupational Therapist in Private Practice

Education

Other, 1995

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

The Weston Group IncGroup PAC ID 8123936796, 215 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• The Weston Group Inc.

  dba The Weston Health Care Group Inc

  • Physical Therapist
  • Acworth, GA
  • NPI 1841309101

  Occupational Therapist

  Medicare reassignment Care Compare group NPD
• Paxxon Healthcare Services LLC

  • Physical Therapist
  • Alpharetta, GA
  • NPI 1386917532

  Occupational Therapist

  Medicare reassignment NPD
• Paxxon Healthcare Services LLC

  • Physical Therapist
  • Colorado Springs, CO
  • NPI 1336808146

  Occupational Therapist

  NPD
• The Weston Group Inc.

  • Physical Therapist
  • Easton, PA
  • NPI 1750250759
  NPD

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

{
    "created_epoch": "1335139200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1581033600000",
    "number": "1508124942",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "45 DOVER CLIFF WAY",
            "city": "JOHNS CREEK",
            "state": "GA",
            "postal_code": "300223202",
            "telephone_number": "678-849-5847"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11190 MEDLOCK BRIDGE RD",
            "city": "DULUTH",
            "state": "GA",
            "postal_code": "300972578",
            "telephone_number": "678-849-5847"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EDGE",
        "first_name": "KIMBRA",
        "middle_name": "SUZANNE",
        "name_prefix": "Mrs.",
        "credential": "OTR/L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-04-23",
        "last_updated": "2020-02-07",
        "certification_date": "2020-02-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "GA",
            "license": "OT002070",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Duska V Dyer, MD
• Ain Ealey
• East West RX Comp LLC (East West Rx Compounding)
• Eben Applied Behavior Analysis, LLC
• Karima M Eboo
• Elizabeth Ashley Edouard, LPC
• Fabienne Edouard
• Gary D Edwards Jr.
• Ken E Edwards III, DDS
• Egleston Affliated Services

• Occupational Therapist in Duluth, GA
• Providers in Duluth, GA by specialty
• Occupational Therapist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.