Active NPI
Regina Cannella, COTA/L
- Contractor
- Palm Coast, FL
National Provider Identifier
1326229071
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Contractor
- License
- OTA10574
- Practice address
- 97 Woodside Dr
Palm Coast, FL 32164-7995 - Phone
- (206) 931-2387
- NPI assigned
- Nov 23, 2007
- Last updated
- Nov 23, 2007
- 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 |
|---|---|---|---|---|
| Contractor | 171W00000X | OTA10574 | FL | Primary |
Addresses
Primary practice location
97 Woodside Dr
Palm Coast, FL 32164-7995
Mailing address
97 Woodside Dr
Palm Coast, FL 32164-7995
Phone (206) 931-2387
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 |
|---|---|---|---|
| OTA10574 | FL | MD | Contractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1195776000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1195776000000",
"number": "1326229071",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "97 WOODSIDE DR",
"city": "PALM COAST",
"state": "FL",
"postal_code": "321647995",
"telephone_number": "206-931-2387"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "97 WOODSIDE DR",
"city": "PALM COAST",
"state": "FL",
"postal_code": "321647995",
"telephone_number": "206-931-2387"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CANNELLA",
"first_name": "REGINA",
"credential": "COTA/L",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-11-23",
"last_updated": "2007-11-23",
"status": "A"
},
"taxonomies": [
{
"code": "171W00000X",
"taxonomy_group": "",
"desc": "Contractor",
"state": "FL",
"license": "OTA10574",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Palm Coast, FL
- Angus Ferguson Campbell
- Michael Patrick Campbell, M.D.
- Trista Nicole Campbell, RBT
- Brandon R Canaday, DMD
- Cancer Specialists, LLC (Cancer Specialists of North Florida)
- Capstone Health Jacksonville, LLC (Vital Care of Palm Coast)
- Kristin Noelle Cardo Colton, ARNP
- Care Right Care LLC (Care Right)
- James Carey, PA-C
- Caring Hands of Love, LLC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 23, 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.