Ingrid Suzanne Derstine, OTD, ORT/L

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

0119008264 Issued in VA

Practice address

14366 Sommerville CT
Midlothian, VA 23113-6838

Phone

(631) 580-5200

Fax

(631) 580-5222

NPI assigned

Sep 16, 2019

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

State licenses

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

{
    "created_epoch": "1568592000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1568592000000",
    "number": "1962052506",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1377 MOTOR PKWY STE 307",
            "city": "ISLANDIA",
            "state": "NY",
            "postal_code": "117495258",
            "telephone_number": "631-580-5200",
            "fax_number": "631-580-5222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14366 SOMMERVILLE CT",
            "city": "MIDLOTHIAN",
            "state": "VA",
            "postal_code": "231136838",
            "telephone_number": "631-580-5200",
            "fax_number": "631-580-5222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DERSTINE",
        "first_name": "INGRID",
        "middle_name": "SUZANNE",
        "credential": "OTD, ORT/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-09-16",
        "last_updated": "2019-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "VA",
            "license": "0119008264",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cory Daniel Denton
• Genevieve Denue
• Debra Ann Denzler, P.T.
• Arpita Gupta Depalma, M.D.
• Melanie Griffin Derry, M.S., CCC/SLP
• Jared J Destro, DC, ATC
• James Detrick
• Priyanjali Devan
• Amanda Ray Devaney, NP
• Sarah Devany, IBCLC

• Occupational Therapist in Midlothian, VA
• Providers in Midlothian, VA by specialty
• Occupational Therapist in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2019; 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.