Individual provider Active NPI

Janell Davis

  • Pediatric Occupational Therapist
  • Niceville, FL
National Provider Identifier
1205600418
Registry record updated Nov 8, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Occupational TherapistTaxonomy code 225XP0200X
License
24740 Issued in FL
Practice address
4565 Commercial Dr Ste 105
Niceville, FL 32578-8856
Phone
(850) 353-2415
NPI assigned
Nov 8, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 8, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Occupational Therapist 225XP0200X 24740 FL Primary

Addresses

Primary practice location

4565 Commercial Dr Ste 105
Niceville, FL 32578-8856

Mailing address

4320 Commons Dr W Unit 2324
Destin, FL 32541-8651

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
24740FLMDPediatric Occupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Kidz Korner Pediatrics CurrentSince Nov 12, 2023 Accepting new patients
Shine-Pediatric Therapy Center CurrentSince Oct 12, 2025 Accepting new patients

Locations

4565 Commercial Dr
Ste 105
Niceville, FL 32578
Phone (850) 353-2415

Organizations & group practices 2

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": "1699401600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1699401600000",
    "number": "1205600418",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4320 COMMONS DR W UNIT 2324",
            "city": "DESTIN",
            "state": "FL",
            "postal_code": "325418651"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4565 COMMERCIAL DR STE 105",
            "city": "NICEVILLE",
            "state": "FL",
            "postal_code": "325788856",
            "telephone_number": "850-353-2415"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "JANELL",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-11-08",
        "last_updated": "2023-11-08",
        "certification_date": "2023-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "FL",
            "license": "24740",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Niceville, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2023; 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.