Individual provider Active NPI

Sarah Stevenson, MS, OTR/L

  • Pediatric Occupational Therapist
  • Fort Walton Beach, FL
National Provider Identifier
1285225649
Registry record updated Jan 29, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Occupational TherapistTaxonomy code 225XP0200X
License
21490 Issued in FL
Practice address
220 Eglin Pkwy SE
Fort Walton Beach, FL 32548-5899
Phone
(850) 200-4348
Fax
(850) 200-4350
NPI assigned
Jan 28, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 29, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Occupational TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225XP0200X 21490 FL Primary

Addresses

Primary practice location

220 Eglin Pkwy SE
Fort Walton Beach, FL 32548-5899

Mailing address

208 S Pinehurst LN
Yorktown, IN 47396-9339
Phone (260) 446-4995

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

LicenseStateTypeSpecialty
21490FLMDPediatric Occupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Kidz Korner Pediatrics CurrentSince May 8, 2022 Accepting new patients

Locations

220 Eglin Pkwy SE
Fort Walton Beach, FL 32548
Phone (850) 200-4348

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": "1611792000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611878400000",
    "number": "1285225649",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "208 S PINEHURST LN",
            "city": "YORKTOWN",
            "state": "IN",
            "postal_code": "473969339",
            "telephone_number": "260-446-4995"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "220 EGLIN PKWY SE",
            "city": "FORT WALTON BEACH",
            "state": "FL",
            "postal_code": "325485899",
            "telephone_number": "850-200-4348",
            "fax_number": "850-200-4350"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEVENSON",
        "first_name": "SARAH",
        "credential": "MS, OTR/L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-01-28",
        "last_updated": "2021-01-29",
        "certification_date": "2021-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XP0200X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "FL",
            "license": "21490",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Walton Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2021; 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.