Active NPI
Theresa Bowen, MOT, OTR/L
- Occupational Therapist
- St. Petersburg, FL
National Provider Identifier
1346611142
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- OT 17160
- Practice address
- 810 S. Village Drive N
#103
St. Petersburg, FL 33716 - Phone
- (727) 385-2841
- NPI assigned
- Oct 19, 2015
- 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 | OT 17160 | FL | Primary |
Addresses
Primary practice location
810 S. Village Drive N
#103
St. Petersburg, FL 33716
Mailing address
810 S. Village Drive N
#103
St. Petersburg, FL 33716
Phone (727) 385-2841
Other practice location 1
1000 W Broadway St Ste 214
Oviedo, FL 32765-9262
Phone (407) 792-5693
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 |
|---|---|---|---|
| OT 17160 | FL | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1445212800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1589846400000",
"number": "1346611142",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "810 S. VILLAGE DRIVE N",
"address_2": "#103",
"city": "ST. PETERSBURG",
"state": "FL",
"postal_code": "33716",
"telephone_number": "727-385-2841"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "810 S. VILLAGE DRIVE N",
"address_2": "#103",
"city": "ST. PETERSBURG",
"state": "FL",
"postal_code": "33716",
"telephone_number": "727-385-2841"
}
],
"practiceLocations": [
{
"address_1": "1000 W Broadway St Ste 214",
"address_purpose": "LOCATION",
"city": "Oviedo",
"state": "FL",
"postal_code": "327659262",
"country_code": "US",
"telephone_number": "407-792-5693",
"fax_number": "407-792-5693",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "BOWEN",
"first_name": "THERESA",
"name_prefix": "Ms.",
"credential": "MOT, OTR/L",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2015-10-19",
"last_updated": "2020-05-19",
"certification_date": "2020-05-19",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "FL",
"license": "OT 17160",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in St. Petersburg, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.