Individual provider Active NPI

Courtney Degraffenreid-Elliott, OT

  • Occupational Therapist
  • Atlanta, GA
National Provider Identifier
1710445127
Registry record updated Mar 5, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
OT006822 Issued in GA
Practice address
2848 Lenox Rd NE
Atlanta, GA 30324-6004
Phone
(678) 249-7120
NPI assigned
Mar 5, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 5, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X OT006822 GA Primary

Addresses

Primary practice location

2848 Lenox Rd NE
Atlanta, GA 30324-6004

Mailing address

PO Box 500
Dallas, GA 30132-0009
Phone (678) 249-7120

Other identifiers 1

IdentifierTypeStateIssuer
OT006822OtherGALICENSE NUMBER

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190418000536 GA Practitioner - Occupational Therapist in Private Practice 4688915739 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Empowerme Rehabilitation Georgia, LLCGroup PAC ID 4284063835, 80 clinicians

Practice addresses (Care Compare)

5610 Hampton Park Dr
Cumming, GA 30041-4004
Phone (470) 866-5540

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OT006822GAMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Empowerme Rehabilitation Georgia, LLC Occupational Therapist CurrentSince Apr 1, 2022 Accepting new patients
Dove Rehab, LLC CurrentSince Feb 12, 2019 Accepting new patients
Functional Pathways Preferred of Tennessee LLC Occupational Therapist CurrentSince Jan 20, 2020 Accepting new patients
Empowerme Medical Group, PC CurrentSince Sep 21, 2025 Accepting new patients
Empowerme Medical Group, PC CurrentSince Sep 21, 2025 Accepting new patients

Locations

5610 Hampton Park Dr
Cumming, GA 30041
Phone (470) 866-5540

9 Sherwood Ln SE
Marietta, GA 30067
Phone (404) 642-5497

4455 Lower Roswell Rd
Unit 683641
Marietta, GA 30068

5701 Spalding Dr
Peachtree Corners, GA 30092
Phone (470) 706-8162

1335 Strassner Dr
Saint Louis, MO 63144
Phone (314) 673-6723

10133 Sherrill Blvd
Ste 200
Knoxville, TN 37932
Phone (865) 392-2847

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1551744000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1551744000000",
    "number": "1710445127",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 500",
            "city": "DALLAS",
            "state": "GA",
            "postal_code": "301320009",
            "telephone_number": "678-249-7120"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2848 LENOX RD NE",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303246004",
            "telephone_number": "678-249-7120"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEGRAFFENREID-ELLIOTT",
        "first_name": "COURTNEY",
        "credential": "OT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-03-05",
        "last_updated": "2019-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "GA",
            "license": "OT006822",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE NUMBER",
            "identifier": "OT006822",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2019; 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.