Active NPI
Nicole Marie Stablum, OTR-L
- Occupational Therapist
- Boca Raton, FL
National Provider Identifier
1205094596
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- OT 7161
- Practice address
- 6551 Park of Commerce Blvd
Boca Raton, FL 33487-8218 - Phone
- (800) 906-0514
- NPI assigned
- May 23, 2008
- Last updated
- May 23, 2008
- 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 | OC007446L | PA | |
| Occupational Therapist | 225X00000X | OT 7161 | CA | Primary |
Addresses
Primary practice location
6551 Park of Commerce Blvd
Boca Raton, FL 33487-8218
Mailing address
25 Second Ave
West West Terrace
Pottsville, PA 17901
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 |
|---|---|---|---|
| OT 7161 | CA | MD | Occupational Therapist |
| OC007446L | PA | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1211500800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1211500800000",
"number": "1205094596",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "25 SECOND AVE",
"address_2": "WEST WEST TERRACE",
"city": "POTTSVILLE",
"state": "PA",
"postal_code": "17901"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6551 PARK OF COMMERCE BLVD",
"city": "BOCA RATON",
"state": "FL",
"postal_code": "334878218",
"telephone_number": "800-906-0514"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STABLUM",
"first_name": "NICOLE",
"middle_name": "MARIE",
"credential": "OTR-L",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-05-23",
"last_updated": "2008-05-23",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "PA",
"license": "OC007446L",
"primary": false
},
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "CA",
"license": "OT 7161",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Boca Raton, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 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.