Individual provider Active NPI

Rebecca Holzer, COTA/L

  • Occupational Therapy Assistant
  • Eustis, FL
National Provider Identifier
1376846873
Registry record updated Dec 6, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Therapy AssistantTaxonomy code 224Z00000X
License
OT 11524 Issued in FL
Practice address
2810 Ruleme St
Eustis, FL 32726-6527
Phone
(352) 357-1990
NPI assigned
Dec 6, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 6, 2010

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy Assistant 224Z00000X OT 11524 FL Primary
Occupational Therapy Assistant 224Z00000X OP006820 PA

Addresses

Primary practice location

2810 Ruleme St
Eustis, FL 32726-6527

Mailing address

5744 Clark Ave
Bethel Park, PA 15102-2610
Phone (412) 835-5378

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
OT 11524FLMDOccupational Therapy Assistant
OP006820PAMDOccupational Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1291593600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1291593600000",
    "number": "1376846873",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5744 CLARK AVE",
            "city": "BETHEL PARK",
            "state": "PA",
            "postal_code": "151022610",
            "telephone_number": "412-835-5378"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2810 RULEME ST",
            "city": "EUSTIS",
            "state": "FL",
            "postal_code": "327266527",
            "telephone_number": "352-357-1990"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLZER",
        "first_name": "REBECCA",
        "credential": "COTA/L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-12-06",
        "last_updated": "2010-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "FL",
            "license": "OT 11524",
            "primary": true
        },
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "PA",
            "license": "OP006820",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Eustis, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2010; 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.