Active NPI
Jeffrey Edward Richardson, OTR/L
- Occupational Therapist
- Cape Coral, FL
National Provider Identifier
1245548007
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- OT14752
- Practice address
- 216 Santa Barbara Blvd
Cape Coral, FL 33991-2031 - Phone
- (239) 839-3786
- NPI assigned
- Sep 15, 2010
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Physical Rehabilitation Occupational Therapist | 225XP0019X | 273161 | IL | |
| Occupational Therapist | 225X00000X | OT14752 | FL | Primary |
Addresses
Primary practice location
216 Santa Barbara Blvd
Cape Coral, FL 33991-2031
Mailing address
3401 22ND St W
Lehigh Acres, FL 33971-5252
Phone (239) 839-3786
Other practice location 1
3250 Winkler Ave
Fort Myers, FL 33916-9414
Phone (239) 939-4993
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 |
|---|---|---|---|
| OT14752 | FL | MD | Occupational Therapist |
| 273161 | IL | MD | Physical Rehabilitation Occupational Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Skilled Proactive Rehab | Single Specialty | Current | 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": "1284508800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1718064000000",
"number": "1245548007",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3401 22ND ST W",
"city": "LEHIGH ACRES",
"state": "FL",
"postal_code": "339715252",
"telephone_number": "239-839-3786"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "216 SANTA BARBARA BLVD",
"city": "CAPE CORAL",
"state": "FL",
"postal_code": "339912031",
"telephone_number": "239-839-3786"
}
],
"practiceLocations": [
{
"address_1": "3250 Winkler Ave",
"address_purpose": "LOCATION",
"city": "Fort Myers",
"state": "FL",
"postal_code": "339169414",
"country_code": "US",
"telephone_number": "239-939-4993",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "RICHARDSON",
"first_name": "JEFFREY",
"middle_name": "EDWARD",
"name_prefix": "Mr.",
"credential": "OTR/L",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2010-09-15",
"last_updated": "2024-06-11",
"certification_date": "2024-06-11",
"status": "A"
},
"taxonomies": [
{
"code": "225XP0019X",
"taxonomy_group": "",
"desc": "Occupational Therapist, Physical Rehabilitation",
"state": "IL",
"license": "273161",
"primary": false
},
{
"code": "225X00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Occupational Therapist",
"state": "FL",
"license": "OT14752",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Cape Coral, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.