Active NPI
Kim Ellen D'Ambra, OTR
- Occupational Therapist
- Clearwater, FL
National Provider Identifier
1295852853
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- OT12429
- Practice address
- 3141 N McMullen Booth Rd
Clearwater, FL 33761-2035 - Phone
- (727) 723-7735
- Fax
- (727) 726-7696
- NPI assigned
- Mar 26, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | OT12429 | FL | Primary |
Addresses
Primary practice location
3141 N McMullen Booth Rd
Clearwater, FL 33761-2035
Mailing address
899 44TH Ave NE
Saint Petersburg, FL 33703-5123
Phone (727) 525-7949
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
| License | State | Type | Specialty |
|---|---|---|---|
| OT12429 | FL | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1174867200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1295852853",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "899 44TH AVE NE",
"city": "SAINT PETERSBURG",
"state": "FL",
"postal_code": "337035123",
"telephone_number": "727-525-7949"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3141 N MCMULLEN BOOTH RD",
"city": "CLEARWATER",
"state": "FL",
"postal_code": "337612035",
"telephone_number": "727-723-7735",
"fax_number": "727-726-7696"
}
],
"practiceLocations": [],
"basic": {
"last_name": "D'AMBRA",
"first_name": "KIM",
"middle_name": "ELLEN",
"name_prefix": "Mr.",
"credential": "OTR",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-03-26",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "FL",
"license": "OT12429",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Clearwater, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.