Individual provider Active NPI

Peggy Louise Canale, OTA

  • Specialist
  • Boca Raton, FL
National Provider Identifier
1295929057
Registry record updated Sep 4, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
46TA09039900 Issued in NJ
Practice address
5901 Broken Sound Pkwy
Suite 500
Boca Raton, FL 33487-2773
Phone
(800) 875-8999
Fax
(561) 417-7443
NPI assigned
Sep 4, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 4, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 46TA09039900 NJ Primary

Addresses

Primary practice location

5901 Broken Sound Pkwy
Suite 500
Boca Raton, FL 33487-2773

Mailing address

4549 Laurel Ave
Newfield, NJ 08344-2120
Phone (856) 794-9734

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
46TA09039900NJMDSpecialist

Practice roles

OrganizationSpecialtyStatusNew patients
Club Staffing Past Accepting new patients
Club Staffing Past Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1188864000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1188864000000",
    "number": "1295929057",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4549 LAUREL AVE",
            "city": "NEWFIELD",
            "state": "NJ",
            "postal_code": "083442120",
            "telephone_number": "856-794-9734"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5901 BROKEN SOUND PKWY",
            "address_2": "SUITE 500",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334872773",
            "telephone_number": "800-875-8999",
            "fax_number": "561-417-7443"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CANALE",
        "first_name": "PEGGY",
        "middle_name": "LOUISE",
        "name_prefix": "Ms.",
        "credential": "OTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-09-04",
        "last_updated": "2007-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NJ",
            "license": "46TA09039900",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boca Raton, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 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.

Verify at the official NPI Registry.