Carly Black, MOT, OTR/L

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

20258 Issued in FL

Practice address

1157 Beach Blvd
Jacksonville Beach, FL 32250-3445

Phone

(904) 450-5061

NPI assigned

Sep 25, 2019

Sex

Female

Sole proprietor

No

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

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

{
    "created_epoch": "1569369600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1786406400000",
    "number": "1184275752",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12276 SAN JOSE BLVD STE 508",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322238618",
            "telephone_number": "904-886-3223",
            "fax_number": "904-485-8876"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1157 BEACH BLVD",
            "city": "JACKSONVILLE BEACH",
            "state": "FL",
            "postal_code": "322503445",
            "telephone_number": "904-450-5061"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLACK",
        "first_name": "CARLY",
        "credential": "MOT, OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-09-25",
        "last_updated": "2026-08-11",
        "certification_date": "2026-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "FL",
            "license": "20258",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Betty Anne Mincey MD PA
• Laura Nance Beverly, M.D.
• Bio-Medical Applications of Florida, Inc.
• Mary Cora Bird
• Diana Rogers Bishop, NP
• Blue Star Therapeutics Inc
• Catherine Ann Bobenrieth, M.D
• Reese Nola Bobo
• Betty Boddie, PT, DPT
• Kathleen Gersek Bodkin, RD, LD/N,CDE

• Occupational Therapist in Jacksonville Beach, FL
• Providers in Jacksonville Beach, FL by specialty
• Occupational Therapist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2026; 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.