Individual provider Active NPI

Jeanette Ann Lingholm, COTA

  • Occupational Therapy Assistant
  • Boynton Beach, FL
National Provider Identifier
1306005210
Registry record updated Aug 19, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Therapy AssistantTaxonomy code 224Z00000X
License
C2023 Issued in WV
Practice address
510 NW 8TH CT
Boynton Beach, FL 33426-3508
Phone
(561) 369-5420
NPI assigned
Jun 5, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 19, 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 C2023 WV Primary
Occupational Therapy Assistant 224Z00000X OTA9423 FL

Addresses

Primary practice location

510 NW 8TH CT
Boynton Beach, FL 33426-3508

Mailing address

510 NW 8TH CT
Boynton Beach, FL 33426-3508
Phone (561) 369-5420

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
OTA9423FLMDOccupational Therapy Assistant
C2023WVMDOccupational Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1212624000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1755561600000",
    "number": "1306005210",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "510 NW 8TH CT",
            "city": "BOYNTON BEACH",
            "state": "FL",
            "postal_code": "334263508",
            "telephone_number": "561-369-5420"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "510 NW 8TH CT",
            "city": "BOYNTON BEACH",
            "state": "FL",
            "postal_code": "334263508",
            "telephone_number": "561-369-5420"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LINGHOLM",
        "first_name": "JEANETTE",
        "middle_name": "ANN",
        "name_prefix": "Ms.",
        "credential": "COTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-06-05",
        "last_updated": "2025-08-19",
        "certification_date": "2025-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "WV",
            "license": "C2023",
            "primary": true
        },
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "FL",
            "license": "OTA9423",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boynton Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 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.