Individual provider Active NPI

Mary Aninos, OTRL

  • Occupational Therapist
  • Fort Walton Beach, FL
National Provider Identifier
1073989620
Registry record updated Aug 18, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
OT 17178 Issued in FL
Practice address
2104 Lewis Turner Blvd
Fort Walton Beach, FL 32547-1316
Phone
(850) 862-3728
Fax
(850) 862-6270
NPI assigned
Aug 18, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 18, 2015

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 OT 17178 FL Primary

Addresses

Primary practice location

2104 Lewis Turner Blvd
Fort Walton Beach, FL 32547-1316

Mailing address

2104 Lewis Turner Blvd
Ft Walton Beach, FL 32547
Phone (850) 862-3728

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250422003526 FL Practitioner - Occupational Therapist in Private Practice 5092230052 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Action Therapy Group LLCGroup PAC ID 6305258013, 69 clinicians

Practice addresses (Care Compare)

2310 Abbie LN
Pensacola, FL 32514-5983
Phone (850) 741-6715

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OT 17178FLMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Action Therapy Group LLC CurrentSince Apr 1, 2025 Accepting new patients
Complete Rehabilitation Services, Inc. Past Accepting new patients

Locations

3964 Florida Ave
Jay, FL 32565
Phone (850) 675-4000

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1439856000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1439856000000",
    "number": "1073989620",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2104 LEWIS TURNER BLVD",
            "city": "FT WALTON BEACH",
            "state": "FL",
            "postal_code": "32547",
            "telephone_number": "850-862-3728",
            "fax_number": "850-862-6270"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2104 LEWIS TURNER BLVD",
            "city": "FORT WALTON BEACH",
            "state": "FL",
            "postal_code": "325471316",
            "telephone_number": "850-862-3728",
            "fax_number": "850-862-6270"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANINOS",
        "first_name": "MARY",
        "credential": "OTRL",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-08-18",
        "last_updated": "2015-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "FL",
            "license": "OT 17178",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Walton Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.