Individual provider Active NPI

Shafranna Camille Abraham, OTR/L

  • Physical Rehabilitation Occupational Therapist
  • Lake Worth, FL
National Provider Identifier
1255733168
Registry record updated Sep 23, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Rehabilitation Occupational TherapistTaxonomy code 225XP0019X
License
A165783688340 Issued in FL
Practice address
10149 Oak Meadow LN
Lake Worth, FL 33449-5468
Phone
(954) 612-8206
Fax
(561) 642-3384
NPI assigned
Sep 23, 2014
Last updated
Sep 23, 2014By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 23, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Rehabilitation Occupational Therapist 225XP0019X A165783688340 FL Primary

Addresses

Primary practice location

10149 Oak Meadow LN
Lake Worth, FL 33449-5468

Mailing address

10149 Oak Meadow LN
Lake Worth, FL 33449-5468
Phone (954) 612-8206

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150826002678 FL Practitioner - Occupational Therapist in Private Practice 0446566012 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
A165783688340FLMDPhysical Rehabilitation Occupational Therapist

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1411430400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1411430400000",
    "number": "1255733168",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10149 OAK MEADOW LN",
            "city": "LAKE WORTH",
            "state": "FL",
            "postal_code": "334495468",
            "telephone_number": "954-612-8206",
            "fax_number": "561-642-3384"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10149 OAK MEADOW LN",
            "city": "LAKE WORTH",
            "state": "FL",
            "postal_code": "334495468",
            "telephone_number": "954-612-8206",
            "fax_number": "561-642-3384"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ABRAHAM",
        "first_name": "SHAFRANNA",
        "middle_name": "CAMILLE",
        "name_prefix": "Mrs.",
        "credential": "OTR/L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-09-23",
        "last_updated": "2014-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XP0019X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Physical Rehabilitation",
            "state": "FL",
            "license": "A165783688340",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Worth, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.