Active NPI
Heidi Coomer Pennella, OTR L
- Pediatric Occupational Therapist
- Tampa, FL
National Provider Identifier
1215055652
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Occupational Therapist
- License
- 10509
- Practice address
- 16546 N Dale Mabry Hwy
Tampa, FL 33618-1325 - Phone
- (813) 964-8481
- NPI assigned
- Mar 26, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Occupational Therapist | 225XP0200X | 10509 | FL | Primary |
Addresses
Primary practice location
16546 N Dale Mabry Hwy
Tampa, FL 33618-1325
Mailing address
18211 Clay Hill Rd
Dade City, FL 33523-6476
Phone (813) 404-3232
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 |
|---|---|---|---|
| 10509 | FL | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1174867200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1215055652",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "18211 CLAY HILL RD",
"city": "DADE CITY",
"state": "FL",
"postal_code": "335236476",
"telephone_number": "813-404-3232"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "16546 N DALE MABRY HWY",
"city": "TAMPA",
"state": "FL",
"postal_code": "336181325",
"telephone_number": "813-964-8481"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PENNELLA",
"first_name": "HEIDI",
"middle_name": "COOMER",
"credential": "OTR L",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-03-26",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "225XP0200X",
"taxonomy_group": "",
"desc": "Occupational Therapist, Pediatrics",
"state": "FL",
"license": "10509",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Tampa, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.