Tracy Renna, OTR

Individual provider Active NPI Occupational Therapist · Oxford, FL

NPI 1285960229 · NPPES record last updated Oct 27, 2019

Key facts

NPI
1285960229
Entity type
Individual (NPI type 1)
Primary specialty
Occupational Therapist 225X00000X
License
OT14017 (FL)
Practice address
4904 NE 123Rd LN
Oxford, FL 34484
Phone
(352) 512-6513
NPI assigned
Oct 27, 2009
Sex
Female
Sole proprietor
Yes

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.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes

Practice roles

OrganizationSpecialtyStatusNew patients
Natural Therapy Group, LLC Single Specialty Past
since Nov 1, 2019
Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist
Group: 193400000X SINGLE SPECIALTY GROUP
225X00000X OT14017 FL Yes

Addresses

Primary practice location

4904 NE 123Rd LN
Oxford, FL 34484

Mailing address

4904 NE 123Rd LN
Oxford, FL 34484-9630
Phone (352) 512-6513

Other practice location 1

2050 Tilden Ave
Box 1000
New Hartford, NY 13413-3613
Phone (315) 797-3114 ext. 2272

Other identifiers

IdentifierTypeStateIssuer
00313539MedicaidNY
01815443MedicaidNY

Other providers in Oxford, FL

All providers in Oxford, FL · Occupational Therapist in Florida

Sources for this page

Verify at the official NPI Registry.