Individual provider Active NPI

Katherin Fraga, COTA/L

  • Occupational Therapy Assistant
  • Cape Coral, FL
National Provider Identifier
1083382980
Registry record updated Sep 3, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Therapy AssistantTaxonomy code 224Z00000X
License
18563 Issued in FL
Practice address
1307 SE 13TH Ter
Cape Coral, FL 33990-3717
Phone
(239) 440-4892
NPI assigned
Sep 3, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 3, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy AssistantGroup: 193400000X SINGLE SPECIALTY GROUP 224Z00000X 18563 FL Primary

Addresses

Primary practice location

1307 SE 13TH Ter
Cape Coral, FL 33990-3717

Mailing address

1307 SE 13TH Ter
Cape Coral, FL 33990-3717
Phone (239) 440-4892

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
18563FLMDPastoral Counselor

NPI Registry JSON

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

{
    "created_epoch": "1630627200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1630627200000",
    "number": "1083382980",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1307 SE 13TH TER",
            "city": "CAPE CORAL",
            "state": "FL",
            "postal_code": "339903717",
            "telephone_number": "239-440-4892"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1307 SE 13TH TER",
            "city": "CAPE CORAL",
            "state": "FL",
            "postal_code": "339903717",
            "telephone_number": "239-440-4892"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FRAGA",
        "first_name": "KATHERIN",
        "credential": "COTA/L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-09-03",
        "last_updated": "2021-09-03",
        "certification_date": "2021-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Occupational Therapy Assistant",
            "state": "FL",
            "license": "18563",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cape Coral, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2021; 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.