Individual provider Active NPI

Kayla Bernal, COTA/L

  • Occupational Therapy Assistant
  • Clermont, FL
National Provider Identifier
1144774761
Registry record updated Oct 11, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Therapy AssistantTaxonomy code 224Z00000X
License
OTA15239 Issued in FL
Practice address
3802 Cinnamon Fern Loop
Clermont, FL 34714-4924
Phone
(786) 246-2403
NPI assigned
Aug 11, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 11, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy Assistant 224Z00000X OTA15239 FL Primary

Addresses

Primary practice location

3802 Cinnamon Fern Loop
Clermont, FL 34714-4924

Mailing address

3802 Cinnamon Fern Loop
Clermont, FL 34714-4924
Phone (786) 246-2403

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
OTA15239FLMDOccupational Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1470873600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1476144000000",
    "number": "1144774761",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3802 CINNAMON FERN LOOP",
            "city": "CLERMONT",
            "state": "FL",
            "postal_code": "347144924",
            "telephone_number": "786-246-2403"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3802 CINNAMON FERN LOOP",
            "city": "CLERMONT",
            "state": "FL",
            "postal_code": "347144924",
            "telephone_number": "786-246-2403"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERNAL",
        "first_name": "KAYLA",
        "credential": "COTA/L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-08-11",
        "last_updated": "2016-10-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "FL",
            "license": "OTA15239",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clermont, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 2016; 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.