Courtney Ly Mott, OTR/L – Occupational Therapist

Key facts

NPI: 1376042846
Entity type: Individual (NPI type 1)
Primary specialty: Occupational Therapist 225X00000X
License: OT18291 (FL)
Practice address: 6550 N Wickham Rd Ste 8
Melbourne, FL 32940-2038
Phone: (407) 694-3603
NPI assigned: Feb 9, 2018
Sex: Female
Sole proprietor: No

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.

Angela Atcheson Taylor LLC Speech-Language Pathologist · Rockledge, FL · NPI 1801155692

NPD (past)
Speech Innovations of Central Florida LLC Speech-Language Pathologist · Melbourne, FL · NPI 1982268173

NPD (past) OCCUPATIONAL THERAPIST

Medicare participation

Medicare fee-for-service enrollment: Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD): No

State licenses

License	State	Type	Specialty
OT18291	FL	MD	Occupational Therapist

Practice roles

Organization	Specialty	Status	New patients
Speech Innovations of Central Florida LLC	Occupational Therapist	Past since Jan 19, 2020	Accepting new patients
Angela Atcheson Taylor LLC		Past	Accepting new patients

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Occupational Therapist	225X00000X	OT18291	FL	Yes
Occupational Therapist	225X00000X

Addresses

Primary practice location

6550 N Wickham Rd Ste 8
Melbourne, FL 32940-2038

Mailing address

6555 N Wickham Rd Ste 8
Melbourne, FL 32940-2040
Phone (407) 694-3603

Other practice location 1

6520 3rd Street
Rockledge, FL 32955
Phone (321) 622-8792

Electronic endpoints

Type	Endpoint	Use	Affiliation
Other URL	www.speech-innovations.com

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Jan 14, 2020.

{
    "created_epoch": "1518134400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1578960000000",
    "number": "1376042846",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6555 N WICKHAM RD STE 8",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329402040",
            "telephone_number": "407-694-3603"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6550 N WICKHAM RD STE 8",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329402038",
            "telephone_number": "407-694-3603"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6520 3rd Street",
            "address_purpose": "LOCATION",
            "city": "Rockledge",
            "state": "FL",
            "postal_code": "32955",
            "country_code": "US",
            "telephone_number": "321-622-8792",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MOTT",
        "first_name": "COURTNEY",
        "middle_name": "LY",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-02-09",
        "last_updated": "2020-01-14",
        "certification_date": "2020-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "FL",
            "license": "OT18291",
            "primary": true
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "www.speech-innovations.com",
            "affiliation": "N",
            "address_1": "6550 N Wickham Rd Ste 8",
            "city": "Melbourne",
            "state": "FL",
            "country_code": "US",
            "postal_code": "329402038",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Melbourne, FL

All providers in Melbourne, FL · Occupational Therapist in Florida

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 14, 2020. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.