Individual provider Active NPI

Tara Marie Nuzzo, OTR/L

  • Pediatric Occupational Therapist
  • Charleston, SC
National Provider Identifier
1306365176
Registry record updated Sep 13, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Occupational TherapistTaxonomy code 225XP0200X
License
5080 Issued in SC
Practice address
80 Broad St
Charleston, SC 29401-2901
Phone
(864) 408-9509
NPI assigned
Sep 13, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 13, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Occupational Therapist 225XP0200X 5080 SC Primary

Addresses

Primary practice location

80 Broad St
Charleston, SC 29401-2901

Mailing address

15303 Sweet PL
Charleston, SC 29492-2833

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200423001633 NJ Practitioner - Occupational Therapist in Private Practice 6507129384 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5080SCMDPediatric Occupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Thompson Medical and Chiropractic LLC CurrentSince Mar 15, 2024 Accepting new patients
Thompson Medical and Chiropractic LLC CurrentSince Mar 15, 2024 Accepting new patients
Therafit Enterprises of New Jersey Incorporated CurrentSince Dec 9, 2024 Accepting new patients
Therafit Enterprises of New Jersey Incorporated Current Accepting new patients

Locations

443 Highway 34
Ste J
Matawan, NJ 07747
Phone (732) 639-0068

1215 Highway 35
Middletown, NJ 07748
Phone (732) 639-0068

1275 Highway 35
Ste 7
Middletown, NJ 07748
Phone (732) 639-0068

106 Apple St
Ste 100C
Tinton Falls, NJ 07724
Phone (732) 747-5022

Organizations & group practices 4

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": "1505260800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1505260800000",
    "number": "1306365176",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15303 SWEET PL",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294922833"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "80 BROAD ST",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294012901",
            "telephone_number": "864-408-9509"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NUZZO",
        "first_name": "TARA",
        "middle_name": "MARIE",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-09-13",
        "last_updated": "2017-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "SC",
            "license": "5080",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charleston, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.