Individual provider Active NPI

Patricia Kathrine Rourke, M.ED., OTR/L

  • Pediatric Occupational Therapist
  • St Petersburg, FL
National Provider Identifier
1245460195
Registry record updated Mar 1, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Occupational TherapistTaxonomy code 225XP0200X
License
OT17106 Issued in FL
Practice address
501 66TH St N
St Petersburg, FL 33710-6939
Phone
(727) 452-1710
NPI assigned
Jul 24, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 1, 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 OT17106 FL Primary

Addresses

Primary practice location

501 66TH St N
St Petersburg, FL 33710-6939

Mailing address

14046 Miramar Ave Unit a
Madeira Beach, FL 33708-2094
Phone (630) 388-9919

Other identifiers 1

IdentifierTypeStateIssuer
016434200MedicaidFL

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
Credentials
Master of Education

State licenses

LicenseStateTypeSpecialty
OT17106FLMDPediatric Occupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
I.T.S. for Kids, Inc. Past Accepting new patients

Organizations & group practices 1

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": "1248393600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1677628800000",
    "number": "1245460195",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14046 MIRAMAR AVE UNIT A",
            "city": "MADEIRA BEACH",
            "state": "FL",
            "postal_code": "337082094",
            "telephone_number": "630-388-9919"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 66TH ST N",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337106939",
            "telephone_number": "727-452-1710"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROURKE",
        "first_name": "PATRICIA",
        "middle_name": "KATHRINE",
        "name_prefix": "Ms.",
        "credential": "M.ED., OTR/L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-07-24",
        "last_updated": "2023-03-01",
        "certification_date": "2023-03-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "FL",
            "license": "OT17106",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "016434200",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in St Petersburg, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 1, 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.