NPIMap

Organization Active NPI

Isenberg Pediatric Occupational Therapy, Inc.

  • Pediatric Occupational Therapist
  • Panama City, FL
National Provider Identifier
1023266491
Registry record updated Aug 28, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Occupational TherapistTaxonomy code 225XP0200X
License
OT2238 Issued in FL
Legal business name
ISENBERG PEDIATRIC OCCUPATIONAL THERAPY, INC.
Practice address
2685 Jenks Ave
Panama City, FL 32405-4351
Phone
(850) 258-6366
Fax
(850) 522-8022
NPI assigned
Aug 28, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 28, 2008

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

Authorized official

Name
Mrs. Shelley Isenberg Hickman, OTR/LNPI 1184782906
Title
Owner
Phone
(850) 258-6366

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Occupational TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225XP0200X OT2238 FL Primary

Addresses

Primary practice location

2685 Jenks Ave
Panama City, FL 32405-4351

Mailing address

PO Box 568
Lynn Haven, FL 32444-0568
Phone (850) 258-6366

Other identifiers 3

IdentifierTypeStateIssuer
886362800MedicaidFL
810737800MedicaidFL
881001000MedicaidFL

National Provider Directory

National Provider Directory
Tax ID family
Isenberg Pediatric Occup Therapy Inc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1219881600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1219881600000",
    "number": "1023266491",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 568",
            "city": "LYNN HAVEN",
            "state": "FL",
            "postal_code": "324440568",
            "telephone_number": "850-258-6366",
            "fax_number": "850-522-8022"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2685 JENKS AVE",
            "city": "PANAMA CITY",
            "state": "FL",
            "postal_code": "324054351",
            "telephone_number": "850-258-6366",
            "fax_number": "850-522-8022"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ISENBERG PEDIATRIC OCCUPATIONAL THERAPY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-08-28",
        "last_updated": "2008-08-28",
        "status": "A",
        "authorized_official_last_name": "HICKMAN",
        "authorized_official_first_name": "SHELLEY",
        "authorized_official_middle_name": "ISENBERG",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "850-258-6366",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "OTR/L"
    },
    "taxonomies": [
        {
            "code": "225XP0200X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "FL",
            "license": "OT2238",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "886362800",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "810737800",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "881001000",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Panama City, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2008; 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.