Active NPI
Amy Geraldine Olson, OTR/L
- Occupational Therapist
- Lakeland, FL
National Provider Identifier
1154424349
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- OT12452
- Practice address
- 1215 E Orange St
Lakeland, FL 33801-5762 - Phone
- (863) 802-3800
- Fax
- (863) 802-0480
- NPI assigned
- Sep 6, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | OT12452 | FL | Primary |
| Pediatric Occupational Therapist | 225XP0200X | OT12452 | FL |
Addresses
Primary practice location
1215 E Orange St
Lakeland, FL 33801-5762
Mailing address
1215 E Orange St
Lakeland, FL 33801-5762
Phone (863) 802-3800
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 15018301 | Other | FL | CITRUS HMO IND ID |
| 891654300 | Medicaid | FL | |
| OT12452 | Other | FL | OCCUPATIONAL THERAPY |
| Y905L | Other | FL | BCBS FL |
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
| License | State | Type | Specialty |
|---|---|---|---|
| OT12452 | FL | MD | Occupational Therapy Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Pediatric Therapy Services Inc | Pediatrics | Past | Accepting new patients |
Organizations & group practices 1
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1157500800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1214352000000",
"number": "1154424349",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1215 E ORANGE ST",
"city": "LAKELAND",
"state": "FL",
"postal_code": "338015762",
"telephone_number": "863-802-3800",
"fax_number": "863-802-0480"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1215 E ORANGE ST",
"city": "LAKELAND",
"state": "FL",
"postal_code": "338015762",
"telephone_number": "863-802-3800",
"fax_number": "863-802-0480"
}
],
"practiceLocations": [],
"basic": {
"last_name": "OLSON",
"first_name": "AMY",
"middle_name": "GERALDINE",
"name_prefix": "Mrs.",
"credential": "OTR/L",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-09-06",
"last_updated": "2008-06-25",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "FL",
"license": "OT12452",
"primary": true
},
{
"code": "225XP0200X",
"taxonomy_group": "",
"desc": "Occupational Therapist, Pediatrics",
"state": "FL",
"license": "OT12452",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CITRUS HMO IND ID",
"identifier": "15018301",
"state": "FL"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "891654300",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "OCCUPATIONAL THERAPY",
"identifier": "OT12452",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS FL",
"identifier": "Y905L",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Lakeland, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.