Active NPI
Marnie Nicolaus, MOT, OTR/L
- Occupational Therapist
- Orlando, FL
National Provider Identifier
1366958779
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 18838
- Practice address
- 14055 Town Loop Blvd
Orlando, FL 32837-6105 - Phone
- (407) 857-6285
- NPI assigned
- Dec 20, 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 18838 | FL | Primary |
Addresses
Primary practice location
14055 Town Loop Blvd
Orlando, FL 32837-6105
Mailing address
16442 Nelson Park Dr Apt 104
Clermont, FL 34714-5875
Phone (517) 745-4942
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 |
|---|---|---|---|
| 18838 | FL | MD | Occupational Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1513728000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1513728000000",
"number": "1366958779",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "16442 NELSON PARK DR APT 104",
"city": "CLERMONT",
"state": "FL",
"postal_code": "347145875",
"telephone_number": "517-745-4942"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "14055 TOWN LOOP BLVD",
"city": "ORLANDO",
"state": "FL",
"postal_code": "328376105",
"telephone_number": "407-857-6285"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NICOLAUS",
"first_name": "MARNIE",
"name_prefix": "Ms.",
"credential": "MOT, OTR/L",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-12-20",
"last_updated": "2017-12-20",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "FL",
"license": "18838",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Orlando, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 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.