Active NPI
Pepharon Ciceron
- Occupational Therapy Assistant
- Ellenton, FL
National Provider Identifier
1346774585
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapy Assistant
- License
- OTA13446
- Practice address
- 5535 69TH PL E
Ellenton, FL 34222 - Phone
- (415) 596-4671
- NPI assigned
- Apr 14, 2017
- Sex
- Male
- Sole proprietor
- No
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 Therapy Assistant | 224Z00000X | OTA13446 | FL | Primary |
Addresses
Primary practice location
5535 69TH PL E
Ellenton, FL 34222
Mailing address
5535 69TH PL E
Ellenton, FL 34222
Phone (415) 596-4671
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 |
|---|---|---|---|
| OTA13446 | FL | MD | Occupational Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1492128000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1492128000000",
"number": "1346774585",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5535 69TH PL E",
"city": "ELLENTON",
"state": "FL",
"postal_code": "34222",
"telephone_number": "415-596-4671"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5535 69TH PL E",
"city": "ELLENTON",
"state": "FL",
"postal_code": "34222",
"telephone_number": "415-596-4671"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CICERON",
"first_name": "PEPHARON",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2017-04-14",
"last_updated": "2017-04-14",
"status": "A"
},
"taxonomies": [
{
"code": "224Z00000X",
"taxonomy_group": "",
"desc": "Occupational Therapy Assistant",
"state": "FL",
"license": "OTA13446",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Ellenton, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.