Individual provider Active NPI

Cinnamon Lee Evans, MS, OTR/L

  • Occupational Therapist
  • Bradenton, FL
National Provider Identifier
1033468293
Registry record updated Sep 4, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
OT15345 Issued in FL
Practice address
3823 E State Road 64
Bradenton, FL 34208-9041
Phone
(941) 745-5111
Fax
(941) 745-5667
NPI assigned
Sep 4, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 4, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X OT15345 FL Primary

Addresses

Primary practice location

3823 E State Road 64
Bradenton, FL 34208-9041

Mailing address

3823 E State Road 64
Bradenton, FL 34208-9041
Phone (941) 745-5111

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
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
OT15345FLMDOccupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1346716800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1346716800000",
    "number": "1033468293",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3823 E STATE ROAD 64",
            "city": "BRADENTON",
            "state": "FL",
            "postal_code": "342089041",
            "telephone_number": "941-745-5111",
            "fax_number": "941-745-5667"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3823 E STATE ROAD 64",
            "city": "BRADENTON",
            "state": "FL",
            "postal_code": "342089041",
            "telephone_number": "941-745-5111",
            "fax_number": "941-745-5667"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EVANS",
        "first_name": "CINNAMON",
        "middle_name": "LEE",
        "credential": "MS, OTR/L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-09-04",
        "last_updated": "2012-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "FL",
            "license": "OT15345",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bradenton, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 2012; 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.