Individual provider Active NPI

Angela Raulerson, OTR/L

  • Occupational Therapist
  • Okeechobee, FL
National Provider Identifier
1104138429
Registry record updated Jul 2, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
OT8575 Issued in FL
Practice address
1926 Highway 441 N
Okeechobee, FL 34972-1922
Phone
(863) 467-6659
Fax
(863) 763-5603
NPI assigned
Jul 2, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 2, 2010

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 OT8575 FL Primary

Addresses

Primary practice location

1926 Highway 441 N
Okeechobee, FL 34972-1922

Mailing address

1796 Highway 441 N
Okeechobee, FL 34972-1918
Phone (863) 467-6659

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240514000131 FL Practitioner - Occupational Therapist in Private Practice 0244671881

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OT8575FLMDOccupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1278028800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1278028800000",
    "number": "1104138429",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1796 HIGHWAY 441 N",
            "city": "OKEECHOBEE",
            "state": "FL",
            "postal_code": "349721918",
            "telephone_number": "863-467-6659",
            "fax_number": "863-763-5603"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1926 HIGHWAY 441 N",
            "city": "OKEECHOBEE",
            "state": "FL",
            "postal_code": "349721922",
            "telephone_number": "863-467-6659",
            "fax_number": "863-763-5603"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAULERSON",
        "first_name": "ANGELA",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-07-02",
        "last_updated": "2010-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "FL",
            "license": "OT8575",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Okeechobee, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.