Individual provider Active NPI

Larry James Rutland, OTR/L

  • Occupational Therapist
  • Fernandina Beach, FL
National Provider Identifier
1356908420
Registry record updated Jun 1, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
OT21794 Issued in FL
Practice address
22391 Flora Parke Xing Unit a
Fernandina Beach, FL 32034-8005
Phone
(904) 321-9054
Fax
(855) 565-1769
NPI assigned
May 23, 2019
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 1, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X OT21794 FL Primary

Addresses

Primary practice location

22391 Flora Parke Xing Unit a
Fernandina Beach, FL 32034-8005

Mailing address

96232 Ridgewood Cir
Fernandina Beach, FL 32034-8160
Phone (678) 761-2863

Other practice location 1

96232 Ridgewood Cir
Fernandina Beach, FL 32034-8160
Phone (678) 761-2863

Other practice location 2

1401 Tift Ave N Ste B
Tifton, GA 31794-3577
Phone (678) 761-2863

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address admin@ontoptherapy.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220105001922 FL Practitioner - Occupational Therapist in Private Practice 4183015951 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Theraplay LLC CurrentSince Aug 29, 2021 Accepting new patients
On Top Therapy LLC Occupational Therapist CurrentSince Sep 23, 2021 Accepting new patients

Locations

22391 Flora Parke Xing
Unit A
Fernandina Beach, FL 32034
Phone (904) 321-9054

103 City Smitty Dr
Saint Marys, GA 31558

1401 Tift Ave N
Ste B
Tifton, GA 31794
Phone (229) 382-5554

Organizations & group practices 2

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": "1558569600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1685577600000",
    "number": "1356908420",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "96232 RIDGEWOOD CIR",
            "city": "FERNANDINA BEACH",
            "state": "FL",
            "postal_code": "320348160",
            "telephone_number": "678-761-2863",
            "fax_number": "904-775-4478"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22391 FLORA PARKE XING UNIT A",
            "city": "FERNANDINA BEACH",
            "state": "FL",
            "postal_code": "320348005",
            "telephone_number": "904-321-9054",
            "fax_number": "855-565-1769"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "96232 Ridgewood Cir",
            "address_purpose": "LOCATION",
            "city": "Fernandina Beach",
            "state": "FL",
            "postal_code": "320348160",
            "country_code": "US",
            "telephone_number": "678-761-2863",
            "fax_number": "904-775-4478",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1401 Tift Ave N Ste B",
            "address_purpose": "LOCATION",
            "city": "Tifton",
            "state": "GA",
            "postal_code": "317943577",
            "country_code": "US",
            "telephone_number": "678-761-2863",
            "fax_number": "855-565-1769",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RUTLAND",
        "first_name": "LARRY",
        "middle_name": "JAMES",
        "name_prefix": "Mr.",
        "credential": "OTR/L",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-05-23",
        "last_updated": "2023-06-01",
        "certification_date": "2022-03-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "FL",
            "license": "OT21794",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "admin@ontoptherapy.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "22391 Flora Parke Xing Unit A",
            "city": "Fernandina Beach",
            "state": "FL",
            "country_code": "US",
            "postal_code": "320348005",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Fernandina Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.