Individual provider Active NPI

Marissa Rose Kobylski, OTR/L

  • Occupational Therapist
  • Port Saint Lucie, FL
National Provider Identifier
1326448994
Registry record updated Sep 2, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
16544 Issued in FL
Practice address
3314 SE East Snow Rd
Port Saint Lucie, FL 34984-6412
Phone
(772) 418-1640
NPI assigned
Sep 2, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 2, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 16544 FL Primary

Addresses

Primary practice location

3314 SE East Snow Rd
Port Saint Lucie, FL 34984-6412

Mailing address

3314 SE East Snow Rd
Port Saint Lucie, FL 34984-6412
Phone (772) 418-1640

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
16544FLMDOccupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1409616000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1409616000000",
    "number": "1326448994",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3314 SE EAST SNOW RD",
            "city": "PORT SAINT LUCIE",
            "state": "FL",
            "postal_code": "349846412",
            "telephone_number": "772-418-1640"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3314 SE EAST SNOW RD",
            "city": "PORT SAINT LUCIE",
            "state": "FL",
            "postal_code": "349846412",
            "telephone_number": "772-418-1640"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOBYLSKI",
        "first_name": "MARISSA",
        "middle_name": "ROSE",
        "credential": "OTR/L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-09-02",
        "last_updated": "2014-09-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "FL",
            "license": "16544",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Saint Lucie, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2014; 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.