Individual provider Active NPI

Diane Purdy

  • Occupational Therapy Assistant
  • Fort Pierce, FL
National Provider Identifier
1336560002
Registry record updated Dec 26, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Therapy AssistantTaxonomy code 224Z00000X
License
OTA13349 Issued in FL
Practice address
611 S 13TH St
Fort Pierce, FL 34950-4054
Phone
(772) 464-5262
NPI assigned
Dec 26, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 26, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy Assistant 224Z00000X OTA13349 FL Primary

Addresses

Primary practice location

611 S 13TH St
Fort Pierce, FL 34950-4054

Mailing address

319 13TH St SW
Vero Beach, FL 32962-6420
Phone (772) 501-6590

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
OTA13349FLMDOccupational Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1388016000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1388016000000",
    "number": "1336560002",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "319 13TH ST SW",
            "city": "VERO BEACH",
            "state": "FL",
            "postal_code": "329626420",
            "telephone_number": "772-501-6590"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "611 S 13TH ST",
            "city": "FORT PIERCE",
            "state": "FL",
            "postal_code": "349504054",
            "telephone_number": "772-464-5262"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PURDY",
        "first_name": "DIANE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-12-26",
        "last_updated": "2013-12-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "FL",
            "license": "OTA13349",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Pierce, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 26, 2013; 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.