Callie Blake Pedersen, MOT, OTR/L

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

18016 Issued in FL

Practice address

7265 Martin Rd
Milton, FL 32570-5509

Phone

(318) 332-5211

NPI assigned

Jul 31, 2017

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Help on Hooves

  • Occupational Therapist
  • Milton, FL
  • NPI 1063006344
  NPD Authorized official

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

{
    "created_epoch": "1501459200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1612310400000",
    "number": "1154845253",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7265 MARTIN RD",
            "city": "MILTON",
            "state": "FL",
            "postal_code": "325705509",
            "telephone_number": "318-332-5211"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7265 MARTIN RD",
            "city": "MILTON",
            "state": "FL",
            "postal_code": "325705509",
            "telephone_number": "318-332-5211"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7552 Navarre Pkwy",
            "address_purpose": "LOCATION",
            "city": "Navarre",
            "state": "FL",
            "postal_code": "325667305",
            "country_code": "US",
            "telephone_number": "850-939-3944",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PEDERSEN",
        "first_name": "CALLIE",
        "middle_name": "BLAKE",
        "credential": "MOT, OTR/L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-07-31",
        "last_updated": "2021-02-03",
        "certification_date": "2021-02-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "FL",
            "license": "18016",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 2021; 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.