Dyetta D Johnson, COTA/L

Primary specialty

Occupational Therapy AssistantTaxonomy code 224Z00000X

License

10840 Issued in NC

Practice address

83 Saint Johns St
Emporia, VA 23847-6043

Phone

(757) 561-8395

NPI assigned

Nov 2, 2021

Last updated

Nov 2, 2021By the provider in NPPES

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1635811200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635811200000",
    "number": "1790440949",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "83 SAINT JOHNS ST",
            "city": "EMPORIA",
            "state": "VA",
            "postal_code": "238476043"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "83 SAINT JOHNS ST",
            "city": "EMPORIA",
            "state": "VA",
            "postal_code": "238476043",
            "telephone_number": "757-561-8395"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "DYETTA",
        "middle_name": "D",
        "credential": "COTA/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-11-02",
        "last_updated": "2021-11-02",
        "certification_date": "2021-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "NC",
            "license": "10840",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Internal Medicine Specialists of Emporia, P.C.
• Kortni Breanna Ivey, CD (DONA)
• Daniel Roosevelt Jenkins Jr.
• La-Toya Jenkins
• Sarah Jones Jessee, DPT
• Jones LTC Pharmacy, Inc.
• Jessica Loleta Jones
• John Pearman Jones, RPH
• John Pearman Jones Jr.
• Julie B. Hawley, D.D.S., P.C.

• Occupational Therapy Assistant in Emporia, VA
• Providers in Emporia, VA by specialty
• Occupational Therapy Assistant in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2021; 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.