Marcia Jeddrie, OTR/L, CLT, MT

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

OT 12356 Issued in FL

Practice address

7000 Spyglass CT
Suite 120
Viera, FL 32940

Phone

(321) 241-6543

Fax

(321) 241-6513

NPI assigned

Sep 2, 2014

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Specialty

Occupational Therapist in Private Practice

Education

Other, 1999

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Space Coast Lymphedema Clinic LLCGroup PAC ID 9638495724, 6 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Medical Technician

State licenses

Practice roles

Locations

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.

• Space Coast Lymphedema Clinic LLC

  • Physical Therapist
  • Viera, FL
  • NPI 1477959856

  Occupational Therapist

  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1409616000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1524614400000",
    "number": "1285034868",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7000 SPYGLASS CT",
            "address_2": "SUITE 120",
            "city": "VIERA",
            "state": "FL",
            "postal_code": "32940",
            "telephone_number": "321-241-6543",
            "fax_number": "321-241-6513"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7000 SPYGLASS CT",
            "address_2": "SUITE 120",
            "city": "VIERA",
            "state": "FL",
            "postal_code": "32940",
            "telephone_number": "321-241-6543",
            "fax_number": "321-241-6513"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JEDDRIE",
        "first_name": "MARCIA",
        "credential": "OTR/L, CLT, MT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-09-02",
        "last_updated": "2018-04-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "FL",
            "license": "OT 12356",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Yoshita Patel Hosking, DDS, MPH
• Thomas Peter Howard, MD
• Indian River Volunteers in Medicine
• William Anthony Ingram, LCSW
• Karen Jancheson, RPT
• Heather Collins Jellett, R.N.
• Josee Jette-Arcand, M.D.
• Cottrell Jiles
• David J Jocksberger, RPH
• Abigail Anna Johns, BCBA

• Occupational Therapist in Viera, FL
• Providers in Viera, FL by specialty
• Occupational Therapist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.