Individual provider Active NPI

Tracy Lynn Angus, OTR/L

  • Pediatric Occupational Therapist
  • Riverview, FL
National Provider Identifier
1366654261
Registry record updated Sep 29, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Occupational TherapistTaxonomy code 225XP0200X
License
OT11118 Issued in FL
Practice address
7243 US Highway 301 S
Riverview, FL 33578-8399
Phone
(813) 663-9828
NPI assigned
May 4, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 29, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Occupational Therapist 225XP0200X OT11118 FL Primary

Addresses

Primary practice location

7243 US Highway 301 S
Riverview, FL 33578-8399

Mailing address

12208 Langshaw Dr
Thonotosassa, FL 33592-2732

Other identifiers 1

IdentifierTypeStateIssuer
022100400MedicaidFL

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250319003587 FL Practitioner - Occupational Therapist in Private Practice 8527580547 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Lampert'S Home Therapy, Inc. CurrentSince Jan 15, 2025 Accepting new patients
Jennifer a. Leigh, M.S. CCC-SLP, Inc. Pediatrics Past Accepting new patients
Jennifer a. Leigh, M.S. CCC-SLP, Inc. PastSince Jul 4, 2021 Accepting new patients

Locations

8254 118th Ave
Ste 100
Largo, FL 33773
Phone (727) 451-5304

Organizations & group practices 3

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": "1178236800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1506643200000",
    "number": "1366654261",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12208 LANGSHAW DR",
            "city": "THONOTOSASSA",
            "state": "FL",
            "postal_code": "335922732"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7243 US HIGHWAY 301 S",
            "city": "RIVERVIEW",
            "state": "FL",
            "postal_code": "335788399",
            "telephone_number": "813-663-9828"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANGUS",
        "first_name": "TRACY",
        "middle_name": "LYNN",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-04",
        "last_updated": "2017-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "FL",
            "license": "OT11118",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "022100400",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Riverview, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2017; 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.