Active NPI
Derek Watkins Davis, OT
- Occupational Therapist
- Largo, FL
National Provider Identifier
1386915841
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- OT11584
- Practice address
- 9035 Bryan Dairy Rd
Largo, FL 33777-1104 - Phone
- (727) 395-9619
- NPI assigned
- Jan 15, 2012
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | OT11584 | FL | Primary |
Addresses
Primary practice location
9035 Bryan Dairy Rd
Largo, FL 33777-1104
Mailing address
12136 Kay Dr
Seminole, FL 33772-2600
Phone (740) 550-1722
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
| License | State | Type | Specialty |
|---|---|---|---|
| OT11584 | FL | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1326585600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1326585600000",
"number": "1386915841",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12136 KAY DR",
"city": "SEMINOLE",
"state": "FL",
"postal_code": "337722600",
"telephone_number": "740-550-1722"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9035 BRYAN DAIRY RD",
"city": "LARGO",
"state": "FL",
"postal_code": "337771104",
"telephone_number": "727-395-9619"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DAVIS",
"first_name": "DEREK",
"middle_name": "WATKINS",
"credential": "OT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2012-01-15",
"last_updated": "2012-01-15",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "FL",
"license": "OT11584",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Largo, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.