Active NPI
Tina J Thompson
- Occupational Therapist
- Dowling Park, FL
National Provider Identifier
1407004419
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- OT1558
- Practice address
- 10820 Marvin Jones Blvd
Dowling Park, FL 32064-8243 - Phone
- (386) 658-5865
- Fax
- (386) 658-5542
- NPI assigned
- Sep 3, 2008
- Last updated
- Sep 3, 2008
- Sex
- Female
- Sole proprietor
- Yes
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 | OT1558 | FL | Primary |
Addresses
Primary practice location
10820 Marvin Jones Blvd
Dowling Park, FL 32064-8243
Mailing address
PO Box 4226
Dowling Park, FL 32064-1538
Phone (386) 658-2586
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| OT1558 | FL | MD | Occupational Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Acv Community Services LLC | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Rural Health Clinic/Center
- Live Oak, FL
- NPI 1174630693
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1220400000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1220400000000",
"number": "1407004419",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 4226",
"city": "DOWLING PARK",
"state": "FL",
"postal_code": "320641538",
"telephone_number": "386-658-2586"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10820 MARVIN JONES BLVD",
"city": "DOWLING PARK",
"state": "FL",
"postal_code": "320648243",
"telephone_number": "386-658-5865",
"fax_number": "386-658-5542"
}
],
"practiceLocations": [],
"basic": {
"last_name": "THOMPSON",
"first_name": "TINA",
"middle_name": "J",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-09-03",
"last_updated": "2008-09-03",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "FL",
"license": "OT1558",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Dowling Park, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.