Verdaiera Versohn Etienne, OTD, OTR/L

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

OT004670 Issued in GA

Practice address

2401 Cumberland Pkwy SE
Atlanta, GA 30339-1808

Phone

(770) 435-4477

Fax

(770) 435-8413

NPI assigned

Dec 28, 2011

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Verdaiera Versohn Merritt Former name

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

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 and National Provider Directory roles.

• Fox Rehabilitation Ga, LLC

  • Physical Therapist
  • Atlanta, GA
  • NPI 1023544624

  Occupational Therapist

  Medicare reassignment NPD

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

{
    "created_epoch": "1325030400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1325030400000",
    "number": "1710256326",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2222 SULLIVAN TRL",
            "city": "EASTON",
            "state": "PA",
            "postal_code": "180407958",
            "telephone_number": "800-944-9782",
            "fax_number": "610-438-2046"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2401 CUMBERLAND PKWY SE",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303391808",
            "telephone_number": "770-435-4477",
            "fax_number": "770-435-8413"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ETIENNE",
        "first_name": "VERDAIERA",
        "middle_name": "VERSOHN",
        "credential": "OTD, OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-12-28",
        "last_updated": "2011-12-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "GA",
            "license": "OT004670",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "VERDAIERA",
            "last_name": "MERRITT",
            "middle_name": "VERSOHN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Etenritys Path LLC a Counseling and Family Resource Center
• Ethel Care
• Amanda Ethridge
• Marc Orel Etienne, DDS
• Terri-Ann Etienne, LMT
• Jennifer Etkind, MD
• Sharon A Etris, APRN
• Elaina Rose Etter, PHARMD
• Nicholas A Ettinger, MD, PHD
• Alfred Benjamin Eubanks, M.D.

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 28, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.