Active NPI
Bobbie Anne Fosdick, OTD, OTR/L
- Occupational Therapist
- Jacksonville, FL
National Provider Identifier
1336807700
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 463172
- Practice address
- 11401 Old Saint Augustine Rd
Jacksonville, FL 32258-1402 - Phone
- (904) 260-1818
- NPI assigned
- Dec 2, 2021
- 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 | 463172 | FL | Primary |
Addresses
Primary practice location
11401 Old Saint Augustine Rd
Jacksonville, FL 32258-1402
Mailing address
4090 Hodges Blvd Apt 111
Jacksonville, FL 32224-4204
Phone (904) 305-0622
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 |
|---|---|---|---|
| 463172 | FL | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1638403200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1638489600000",
"number": "1336807700",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4090 HODGES BLVD APT 111",
"city": "JACKSONVILLE",
"state": "FL",
"postal_code": "322244204",
"telephone_number": "904-305-0622"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11401 OLD SAINT AUGUSTINE RD",
"city": "JACKSONVILLE",
"state": "FL",
"postal_code": "322581402",
"telephone_number": "904-260-1818"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FOSDICK",
"first_name": "BOBBIE",
"middle_name": "ANNE",
"credential": "OTD, OTR/L",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2021-12-02",
"last_updated": "2021-12-03",
"certification_date": "2021-12-03",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Occupational Therapist",
"state": "FL",
"license": "463172",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Jacksonville, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.