Individual provider Active NPI

Michelle Nicole Spivey, COTA/L

  • Occupational Therapy Assistant
  • Oviedo, FL
National Provider Identifier
1376997601
Registry record updated Apr 22, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Therapy AssistantTaxonomy code 224Z00000X
License
15101 Issued in FL
Practice address
1809 E Broadway St # 122
Oviedo, FL 32765-8597
Phone
(407) 359-5693
Fax
(407) 792-5693
NPI assigned
Apr 22, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 22, 2016

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 15101 FL Primary

Addresses

Primary practice location

1809 E Broadway St # 122
Oviedo, FL 32765-8597

Mailing address

7757 Lauderdale Dr N
Jacksonville, FL 32277-3772
Phone (904) 864-7238

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
15101FLMDOccupational Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1461283200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1461283200000",
    "number": "1376997601",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7757 LAUDERDALE DR N",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322773772",
            "telephone_number": "904-864-7238"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1809 E BROADWAY ST # 122",
            "city": "OVIEDO",
            "state": "FL",
            "postal_code": "327658597",
            "telephone_number": "407-359-5693",
            "fax_number": "407-792-5693"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPIVEY",
        "first_name": "MICHELLE",
        "middle_name": "NICOLE",
        "credential": "COTA/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-04-22",
        "last_updated": "2016-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "FL",
            "license": "15101",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oviedo, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2016; 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.