Individual provider Active NPI

Laura K Culverhouse

  • Occupational Therapy Assistant
  • Green Cove Springs, FL
National Provider Identifier
1376364620
Registry record updated Oct 21, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Therapy AssistantTaxonomy code 224Z00000X
License
OTA12292 Issued in FL
Practice address
801 Oak St
Green Cove Springs, FL 32043-4317
Phone
(904) 284-9230
NPI assigned
Oct 21, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 21, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy Assistant 224Z00000X OTA12292 FL Primary

Addresses

Primary practice location

801 Oak St
Green Cove Springs, FL 32043-4317

Mailing address

2863 Longleaf Ranch Cir
Middleburg, FL 32068-6353
Phone (205) 603-9068

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

LicenseStateTypeSpecialty
OTA12292FLMDOccupational Therapy Assistant

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1729468800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729468800000",
    "number": "1376364620",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2863 LONGLEAF RANCH CIR",
            "city": "MIDDLEBURG",
            "state": "FL",
            "postal_code": "320686353",
            "telephone_number": "205-603-9068"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "801 OAK ST",
            "city": "GREEN COVE SPRINGS",
            "state": "FL",
            "postal_code": "320434317",
            "telephone_number": "904-284-9230"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CULVERHOUSE",
        "first_name": "LAURA",
        "middle_name": "K",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-10-21",
        "last_updated": "2024-10-21",
        "certification_date": "2024-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "FL",
            "license": "OTA12292",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Green Cove Springs, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.