Individual provider Active NPI

Gregory Lamar Brown, OTA

  • Occupational Therapy Assistant
  • Ocala, FL
National Provider Identifier
1073857355
Registry record updated Dec 13, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Therapy AssistantTaxonomy code 224Z00000X
License
OTA9265 Issued in FL
Practice address
3780 SE 55TH CT
Ocala, FL 34480-1339
Phone
(352) 694-6962
NPI assigned
Nov 27, 2012
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 13, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy Assistant 224Z00000X OTA9265 FL Primary

Addresses

Primary practice location

3780 SE 55TH CT
Ocala, FL 34480-1339

Mailing address

3780 SE 55TH CT
Ocala, FL 34480-1339
Phone (352) 694-6962

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
OTA9265FLMDOccupational Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1353974400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1355356800000",
    "number": "1073857355",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3780 SE 55TH CT",
            "city": "OCALA",
            "state": "FL",
            "postal_code": "344801339",
            "telephone_number": "352-694-6962"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3780 SE 55TH CT",
            "city": "OCALA",
            "state": "FL",
            "postal_code": "344801339",
            "telephone_number": "352-694-6962"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROWN",
        "first_name": "GREGORY",
        "middle_name": "LAMAR",
        "credential": "OTA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-11-27",
        "last_updated": "2012-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "FL",
            "license": "OTA9265",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ocala, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 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.