Donna Renee Ussery, PSY. D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

002709 Issued in GA

Practice address

700 Beaver Ruin Rd NW
Suite F
Lilburn, GA 30047-3404

Phone

(770) 925-7895

Fax

(770) 925-8059

NPI assigned

Feb 28, 2007

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

Enrolled in GA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Interoperability endpoints

• Direct secure messaging: dussery44110@choa.gadirect.net

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

{
    "created_epoch": "1172620800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1639206394",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 BEAVER RUIN RD NW",
            "address_2": "SUITE F",
            "city": "LILBURN",
            "state": "GA",
            "postal_code": "300473404",
            "telephone_number": "770-925-7895",
            "fax_number": "770-925-8059"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 BEAVER RUIN RD NW",
            "address_2": "SUITE F",
            "city": "LILBURN",
            "state": "GA",
            "postal_code": "300473404",
            "telephone_number": "770-925-7895",
            "fax_number": "770-925-8059"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "USSERY",
        "first_name": "DONNA",
        "middle_name": "RENEE",
        "name_prefix": "Dr.",
        "credential": "PSY. D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-02-28",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "GA",
            "license": "002709",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERIGROUP",
            "identifier": "01000391",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ultimate Urgent Care &Medical Clinic
• Chisorom Ume
• Unique Therapeutic Services
• United Rehab Inc.
• Claudia Urrego-Torres, DMD
• Valiant Therapy LLC
• Vallabh Chiropractic LLC
• Milagro Abigail Valladares, DC
• Jude Henry Valles, DC
• George Varghese, RPH

• Clinical Psychologist in Lilburn, GA
• Providers in Lilburn, GA by specialty
• Clinical Psychologist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.