Individual provider Active NPI

Waylon Spicer, COTA

  • Low Vision Occupational Therapy Assistant
  • Madison, FL
National Provider Identifier
1023846201
Registry record updated Jul 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Low Vision Occupational Therapy AssistantTaxonomy code 224ZL0004X
Practice address
545 SW Gabriella Way
Madison, FL 32340-8440
Phone
(850) 464-8751
NPI assigned
Jul 22, 2024
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 22, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Low Vision Occupational Therapy Assistant 224ZL0004X Primary

Addresses

Primary practice location

545 SW Gabriella Way
Madison, FL 32340-8440

Mailing address

545 SW Gabriella Way
Madison, FL 32340-8440

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

NPI Registry JSON

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

{
    "created_epoch": "1721606400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721606400000",
    "number": "1023846201",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "545 SW GABRIELLA WAY",
            "city": "MADISON",
            "state": "FL",
            "postal_code": "323408440"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "545 SW GABRIELLA WAY",
            "city": "MADISON",
            "state": "FL",
            "postal_code": "323408440",
            "telephone_number": "850-464-8751"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPICER",
        "first_name": "WAYLON",
        "credential": "COTA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-07-22",
        "last_updated": "2024-07-22",
        "certification_date": "2024-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224ZL0004X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant, Low Vision",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Madison, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 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.

Verify at the official NPI Registry.