Active NPI
Erica Beverly Hill, OT
- Occupational Therapist
- Dacula, GA
National Provider Identifier
1811241367
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- OT004239
- Practice address
- 575 Roland Manor Dr
Dacula, GA 30019-6584 - Phone
- (404) 531-8590
- Fax
- (404) 531-8581
- NPI assigned
- Nov 6, 2012
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | OT004239 | GA | Primary |
Addresses
Primary practice location
575 Roland Manor Dr
Dacula, GA 30019-6584
Mailing address
575 Roland Manor Drive
Dacula, GA 30019
Phone (404) 234-5205
Other practice location 1
3160 Main St Ste 103
Duluth, GA 30096-3461
Phone (404) 955-7202
Other practice location 2
5580 La Jolla Blvd
LA Jolla, CA 92037-7651
Phone (877) 399-3746
Other names 1
- Erica R. Beverly
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 004239 | GA | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Reid Clinic Sports Physical Therapy and Spine LLC | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Physical Therapy Clinic/Center
- Roswell, GA
- NPI 1609106418
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1352160000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1731369600000",
"number": "1811241367",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "575 ROLAND MANOR DRIVE",
"city": "DACULA",
"state": "GA",
"postal_code": "30019",
"telephone_number": "404-234-5205"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "575 ROLAND MANOR DR",
"city": "DACULA",
"state": "GA",
"postal_code": "300196584",
"telephone_number": "404-531-8590",
"fax_number": "404-531-8581"
}
],
"practiceLocations": [
{
"address_1": "3160 Main St Ste 103",
"address_purpose": "LOCATION",
"city": "Duluth",
"state": "GA",
"postal_code": "300963461",
"country_code": "US",
"telephone_number": "404-955-7202",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "5580 La Jolla Blvd",
"address_purpose": "LOCATION",
"city": "LA Jolla",
"state": "CA",
"postal_code": "920377651",
"country_code": "US",
"telephone_number": "877-399-3746",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "HILL",
"first_name": "ERICA",
"middle_name": "BEVERLY",
"credential": "OT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2012-11-06",
"last_updated": "2024-11-12",
"certification_date": "2024-11-12",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "GA",
"license": "OT004239",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "ERICA",
"last_name": "BEVERLY",
"middle_name": "R.",
"credential": "OT",
"code": "1",
"type": "Former Name"
}
]
}
Other providers in Dacula, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.