Individual provider Active NPI

Alycia Gresham, OTR/L

  • Occupational Therapist
  • Sunrise, FL
National Provider Identifier
1295451235
Registry record updated Mar 20, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
OT26065 Issued in FL
Practice address
14201 W Sunrise Blvd Ste 107
Sunrise, FL 33323-3207
Phone
(954) 756-2818
Fax
(954) 514-1126
NPI assigned
Oct 12, 2022
Last updated
Mar 20, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 20, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy Assistant 224Z00000X OTA18115 FL
Occupational Therapist 225X00000X OT26065 FL Primary

Addresses

Primary practice location

14201 W Sunrise Blvd Ste 107
Sunrise, FL 33323-3207

Mailing address

14201 W Sunrise Blvd Ste 107
Sunrise, FL 33323-3207
Phone (954) 756-2818

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

LicenseStateTypeSpecialty
OTA18115FLMDOccupational Therapy Assistant
OT26065FLMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Adults to Pediatrics Therapy LLC Occupational Therapist CurrentSince Nov 24, 2024 Accepting new patients
Pediatric Potentials Therapy Occupational Therapy Assistant PastSince Oct 1, 2022 Accepting new patients

Locations

14201 W Sunrise Blvd
Ste 107
Sunrise, FL 33323
Phone (954) 756-2818

Organizations & group practices 2

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": "1665532800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742428800000",
    "number": "1295451235",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14201 W SUNRISE BLVD STE 107",
            "city": "SUNRISE",
            "state": "FL",
            "postal_code": "333233207",
            "telephone_number": "954-756-2818",
            "fax_number": "954-514-1126"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14201 W SUNRISE BLVD STE 107",
            "city": "SUNRISE",
            "state": "FL",
            "postal_code": "333233207",
            "telephone_number": "954-756-2818",
            "fax_number": "954-514-1126"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRESHAM",
        "first_name": "ALYCIA",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-10-12",
        "last_updated": "2025-03-20",
        "certification_date": "2025-03-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "FL",
            "license": "OTA18115",
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "FL",
            "license": "OT26065",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sunrise, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 2025; 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.