Carissa Marie Hardin, OTR/L

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

25043 Issued in FL

Practice address

2080 W Eau Gallie Blvd
Melbourne, FL 32935-3152

Phone

(407) 694-3603

Fax

(321) 296-7130

NPI assigned

Nov 27, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Specialty

Occupational Therapist in Private Practice

Education

Other, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Axispro Physical Therapy LLCGroup PAC ID 5395035158, 9 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Axispro Physical Therapy LLC

  • Physical Therapy Clinic/Center
  • Melbourne, FL
  • NPI 1821443474

  Occupational Therapist

  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1543276800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709510400000",
    "number": "1114497674",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1194 BACA AVE NW",
            "city": "PALM BAY",
            "state": "FL",
            "postal_code": "329079404",
            "telephone_number": "505-402-8414"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2080 W EAU GALLIE BLVD",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329353152",
            "telephone_number": "407-694-3603",
            "fax_number": "321-296-7130"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARDIN",
        "first_name": "CARISSA",
        "middle_name": "MARIE",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-11-27",
        "last_updated": "2024-03-04",
        "certification_date": "2024-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "TN",
            "license": "3133",
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "FL",
            "license": "25043",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Harbor City Pharmacy Inc
• Harbor City Physical Therapy, PA
• Harbor City Surgical Care
• Katena Harden
• Zachary Tayler Hardesty, M.S.
• Abraham Hardoon, MD
• Scott Hardoon, M.D.
• Godefroy Hardy St-Pierre, M.D.
• Robert Franklin Hardy, CAA
• Stephanie E Haridopolos, M.D.

• Occupational Therapist in Melbourne, FL
• Providers in Melbourne, FL by specialty
• Occupational Therapist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2024; 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.