Active NPI
Mary Renner, OTR/L
- Occupational Therapist
- West Palm Beach, FL
National Provider Identifier
1235407180
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- OT 14859
- Practice address
- 5100 Cresthaven Blvd
West Palm Beach, FL 33415-8618 - Phone
- (561) 964-2828
- NPI assigned
- Dec 7, 2011
- Last updated
- May 14, 2015
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | OT 14859 | FL | Primary |
Addresses
Primary practice location
5100 Cresthaven Blvd
West Palm Beach, FL 33415-8618
Mailing address
934 Pike Rd
West Palm Beach, FL 33411-3849
Phone (727) 520-2953
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)
- Enrolled
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| OT 14859 | FL | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1323216000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1431561600000",
"number": "1235407180",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "934 PIKE RD",
"city": "WEST PALM BEACH",
"state": "FL",
"postal_code": "334113849",
"telephone_number": "727-520-2953"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5100 CRESTHAVEN BLVD",
"city": "WEST PALM BEACH",
"state": "FL",
"postal_code": "334158618",
"telephone_number": "561-964-2828"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RENNER",
"first_name": "MARY",
"credential": "OTR/L",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-12-07",
"last_updated": "2015-05-14",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "FL",
"license": "OT 14859",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in West Palm Beach, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.