Active NPI
Jessica Alyssa Williams, COTA
- Occupational Therapist
- Pembroke Pines, FL
National Provider Identifier
1316212319
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 12163
- Practice address
- 12301 Taft Street
Suite 200
Pembroke Pines, FL 33023 - Phone
- (954) 680-0488
- NPI assigned
- Mar 9, 2012
- 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 | 12163 | FL | Primary |
Addresses
Primary practice location
12301 Taft Street
Suite 200
Pembroke Pines, FL 33023
Mailing address
6166 SW 18TH Street
Apt 1
Miramar, FL 33023
Phone (954) 274-8365
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 |
|---|---|---|---|
| 12163 | FL | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1331251200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1331251200000",
"number": "1316212319",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6166 SW 18TH STREET",
"address_2": "APT 1",
"city": "MIRAMAR",
"state": "FL",
"postal_code": "33023",
"telephone_number": "954-274-8365"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12301 TAFT STREET",
"address_2": "SUITE 200",
"city": "PEMBROKE PINES",
"state": "FL",
"postal_code": "33023",
"telephone_number": "954-680-0488"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILLIAMS",
"first_name": "JESSICA",
"middle_name": "ALYSSA",
"credential": "COTA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2012-03-09",
"last_updated": "2012-03-09",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "FL",
"license": "12163",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Pembroke Pines, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 9, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.