Active NPI
Nicole Bilodeau, MOT,OTR/L
- Occupational Therapist
- Brandon, FL
National Provider Identifier
1316038706
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- OT9979
- Practice address
- 1814 Lakeview Dr
Brandon, FL 33511-6224 - Phone
- (813) 557-5388
- NPI assigned
- Sep 28, 2006
- Last updated
- Aug 24, 2020
- Sex
- Female
- Sole proprietor
- Yes
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 | OT9979 | FL | Primary |
Addresses
Primary practice location
1814 Lakeview Dr
Brandon, FL 33511-6224
Mailing address
1814 Lakeview Dr
Brandon, FL 33511-6224
Phone (813) 557-5388
Other practice location 1
4008 Water Park Ct
Riverview, FL 33578-3038
Phone (813) 362-2359
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in FL
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20110616000287 | FL | Practitioner - Occupational Therapist in Private Practice | 0840477030 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| OT9979 | FL | MD | Occupational Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Nicole Bilodeau, LLC | Occupational Therapist | Current | Accepting new patients |
Organizations & group practices 1
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": "1159401600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1598227200000",
"number": "1316038706",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1814 LAKEVIEW DR",
"city": "BRANDON",
"state": "FL",
"postal_code": "335116224",
"telephone_number": "813-557-5388"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1814 LAKEVIEW DR",
"city": "BRANDON",
"state": "FL",
"postal_code": "335116224",
"telephone_number": "813-557-5388"
}
],
"practiceLocations": [
{
"address_1": "4008 Water Park Ct",
"address_purpose": "LOCATION",
"city": "Riverview",
"state": "FL",
"postal_code": "335783038",
"country_code": "US",
"telephone_number": "813-362-2359",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "BILODEAU",
"first_name": "NICOLE",
"name_prefix": "Mrs.",
"credential": "MOT,OTR/L",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-09-28",
"last_updated": "2020-08-24",
"certification_date": "2020-08-24",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "FL",
"license": "OT9979",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Brandon, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2020; 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.