Individual provider Active NPI

Andrea Johnson Verburg, LPMT, MT-BC

  • Music Therapist
  • Roswell, GA
National Provider Identifier
1972873016
Registry record updated Jun 27, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Music TherapistTaxonomy code 225A00000X
License
MUT000016 Issued in GA
Practice address
12060 Etris Rd
Suite 200
Roswell, GA 30075-1463
Phone
(678) 701-1203
NPI assigned
Jan 6, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 27, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Music Therapist 225A00000X MUT000016 GA Primary

Addresses

Primary practice location

12060 Etris Rd
Suite 200
Roswell, GA 30075-1463

Mailing address

2545 Wainwright Way
Cumming, GA 30041
Phone (404) 661-6491

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
MUT000016GAMDMusic Therapist

NPI Registry JSON

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

{
    "created_epoch": "1325808000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1498521600000",
    "number": "1972873016",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2545 WAINWRIGHT WAY",
            "city": "CUMMING",
            "state": "GA",
            "postal_code": "30041",
            "telephone_number": "404-661-6491"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12060 ETRIS RD",
            "address_2": "SUITE 200",
            "city": "ROSWELL",
            "state": "GA",
            "postal_code": "300751463",
            "telephone_number": "678-701-1203"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VERBURG",
        "first_name": "ANDREA",
        "middle_name": "JOHNSON",
        "name_prefix": "Mrs.",
        "credential": "LPMT, MT-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-01-06",
        "last_updated": "2017-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225A00000X",
            "taxonomy_group": "",
            "desc": "Music Therapist",
            "state": "GA",
            "license": "MUT000016",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Roswell, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2017; 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.