Individual provider Active NPI

Laura Moerman, OTR

  • Physical Rehabilitation Occupational Therapist
  • St Augustine, FL
National Provider Identifier
1114962982
Registry record updated May 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Rehabilitation Occupational TherapistTaxonomy code 225XP0019X
License
OT17721 Issued in FL
Practice address
820 Riley LN
St Augustine, FL 32095-6832
Phone
(904) 575-1750
NPI assigned
Jun 17, 2006
Last updated
May 10, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 10, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 3038-026 WI
Physical Rehabilitation Occupational Therapist 225XP0019X OT17721 FL Primary

Addresses

Primary practice location

820 Riley LN
St Augustine, FL 32095-6832

Mailing address

820 Riley LN
St Augustine, FL 32095-6832
Phone (904) 575-1750

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
3038-026WIMDOccupational Therapist
OT17721FLMDPhysical Rehabilitation Occupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1150502400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1746835200000",
    "number": "1114962982",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "820 RILEY LN",
            "city": "ST AUGUSTINE",
            "state": "FL",
            "postal_code": "320956832",
            "telephone_number": "904-575-1750"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "820 RILEY LN",
            "city": "ST AUGUSTINE",
            "state": "FL",
            "postal_code": "320956832",
            "telephone_number": "904-575-1750"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOERMAN",
        "first_name": "LAURA",
        "credential": "OTR",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-17",
        "last_updated": "2025-05-10",
        "certification_date": "2025-05-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "WI",
            "license": "3038-026",
            "primary": false
        },
        {
            "code": "225XP0019X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Physical Rehabilitation",
            "state": "FL",
            "license": "OT17721",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in St Augustine, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 10, 2025; 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.