Individual provider Active NPI

Kathleen Teresa Nightlinger, MS, OTRL

  • Occupational Therapist
  • Brandon, FL
National Provider Identifier
1376750141
Registry record updated Oct 6, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
OT17263 Issued in FL
Practice address
602 Vonderburg Dr
Suite 201
Brandon, FL 33511-5900
Phone
(813) 653-1149
Fax
(813) 654-6644
NPI assigned
May 17, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 6, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X OC008985 PA
Occupational Therapist 225X00000X OT17263 FL Primary

Addresses

Primary practice location

602 Vonderburg Dr
Suite 201
Brandon, FL 33511-5900

Mailing address

602 Vonderburg Dr
Suite 201
Brandon, FL 33511-5900
Phone (813) 653-1149

Other identifiers 1

IdentifierTypeStateIssuer
015701300MedicaidFL

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
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
OC008985PAMDSpecialist
OT17263FLMDOccupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1179360000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1444089600000",
    "number": "1376750141",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "602 VONDERBURG DR",
            "address_2": "SUITE 201",
            "city": "BRANDON",
            "state": "FL",
            "postal_code": "335115900",
            "telephone_number": "813-653-1149",
            "fax_number": "813-654-6644"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "602 VONDERBURG DR",
            "address_2": "SUITE 201",
            "city": "BRANDON",
            "state": "FL",
            "postal_code": "335115900",
            "telephone_number": "813-653-1149",
            "fax_number": "813-654-6644"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NIGHTLINGER",
        "first_name": "KATHLEEN",
        "middle_name": "TERESA",
        "credential": "MS, OTRL",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-17",
        "last_updated": "2015-10-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "PA",
            "license": "OC008985",
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "FL",
            "license": "OT17263",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "015701300",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brandon, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 2015; 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.