Active NPI
Patricia Walters
- Occupational Therapist
- Port Orange, FL
National Provider Identifier
1346788007
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- OT008529
- Practice address
- 5535 S Williamson Blvd
Ste 774
Port Orange, FL 32128-8311 - Phone
- (888) 265-2680
- NPI assigned
- Feb 2, 2017
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 7
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | OT15975 | CA | |
| Occupational Therapist | 225X00000X | OT 1494 | HI | |
| Occupational Therapist | 225X00000X | 3419 | AL | |
| Occupational Therapist | 225X00000X | 11923 | MA | |
| Occupational Therapist | 225X00000X | OT 17169 | FL | |
| Occupational Therapist | 225X00000X | 291897 | OR | |
| Occupational Therapist | 225X00000X | OT008529 | GA | Primary |
Addresses
Primary practice location
5535 S Williamson Blvd
Ste 774
Port Orange, FL 32128-8311
Mailing address
5535 S Williamson Blvd
Ste 774
Port Orange, FL 32128-8311
Phone (888) 265-2680
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 11923 | MA | MD | Mental Health Counselor |
| 3419 | AL | MD | Dentist |
| OT15975 | CA | MD | Occupational Therapist |
| OT 17169 | FL | MD | Occupational Therapist |
| OT 1494 | HI | MD | Occupational Therapist |
| 291897 | OR | MD | Occupational Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Fox Rehabilitation Ga, LLC | Occupational Therapist | Current | Accepting new patients |
Locations
7 Carnegie Plz
Cherry Hill, NJ 08003
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1485993600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1666137600000",
"number": "1346788007",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5535 S WILLIAMSON BLVD",
"address_2": "STE 774",
"city": "PORT ORANGE",
"state": "FL",
"postal_code": "321288311",
"telephone_number": "888-265-2680"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5535 S WILLIAMSON BLVD",
"address_2": "STE 774",
"city": "PORT ORANGE",
"state": "FL",
"postal_code": "321288311",
"telephone_number": "888-265-2680"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WALTERS",
"first_name": "PATRICIA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-02-02",
"last_updated": "2022-10-19",
"certification_date": "2022-10-19",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "CA",
"license": "OT15975",
"primary": false
},
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "HI",
"license": "OT 1494",
"primary": false
},
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "AL",
"license": "3419",
"primary": false
},
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "MA",
"license": "11923",
"primary": false
},
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "FL",
"license": "OT 17169",
"primary": false
},
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "OR",
"license": "291897",
"primary": false
},
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "GA",
"license": "OT008529",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Port Orange, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.