Active NPI
Occupational Wellness Solutions, Inc
- Occupational Therapist
- Edgewater, FL
National Provider Identifier
1407290406
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 12846
- Legal business name
- OCCUPATIONAL WELLNESS SOLUTIONS, INC
- Practice address
- 501 N Ridgewood Ave Ste B
Edgewater, FL 32132-1627 - Phone
- (386) 795-7563
- Fax
- (800) 320-4585
- NPI assigned
- Apr 20, 2013
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Gina Roberson-Johnson, OTR
- Title
- President
- Phone
- (386) 795-7563
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 7
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapy Assistant | 224Z00000X | 9923 | FL | |
| Physical Therapist | 225100000X | 6759 | FL | |
| Pediatric Physical Therapist | 2251P0200X | 6759 | FL | |
| Physical Therapy Assistant | 225200000X | 22799 | FL | |
| Occupational Therapist | 225X00000X | 12846 | FL | Primary |
| Pediatric Occupational Therapist | 225XP0200X | 12846 | FL | |
| Speech-Language Pathologist | 235Z00000X | 5854 | FL |
Addresses
Primary practice location
501 N Ridgewood Ave Ste B
Edgewater, FL 32132-1627
Mailing address
501 N Ridgewood Ave Ste B
Edgewater, FL 32132-1627
Phone (386) 795-7563
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 008552700 | Medicaid | FL |
National Provider Directory
National Provider DirectoryLocations
501 N Ridgewood Ave
Ste B
Edgewater, FL 32132
Phone (386) 795-7563
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Occupational Therapist
- Edgewater, FL
- NPI 1750570388
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1366416000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1594684800000",
"number": "1407290406",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "501 N RIDGEWOOD AVE STE B",
"city": "EDGEWATER",
"state": "FL",
"postal_code": "321321627",
"telephone_number": "386-795-7563"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "501 N RIDGEWOOD AVE STE B",
"city": "EDGEWATER",
"state": "FL",
"postal_code": "321321627",
"telephone_number": "386-795-7563",
"fax_number": "800-320-4585"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "OCCUPATIONAL WELLNESS SOLUTIONS, INC",
"organizational_subpart": "NO",
"enumeration_date": "2013-04-20",
"last_updated": "2020-07-14",
"certification_date": "2020-07-14",
"status": "A",
"authorized_official_last_name": "ROBERSON-JOHNSON",
"authorized_official_first_name": "GINA",
"authorized_official_title_or_position": "PRESIDENT",
"authorized_official_telephone_number": "386-795-7563",
"authorized_official_credential": "OTR"
},
"taxonomies": [
{
"code": "224Z00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Occupational Therapy Assistant",
"state": "FL",
"license": "9923",
"primary": false
},
{
"code": "225100000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Physical Therapist",
"state": "FL",
"license": "6759",
"primary": false
},
{
"code": "2251P0200X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Physical Therapist, Pediatrics",
"state": "FL",
"license": "6759",
"primary": false
},
{
"code": "225200000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Physical Therapy Assistant",
"state": "FL",
"license": "22799",
"primary": false
},
{
"code": "225X00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Occupational Therapist",
"state": "FL",
"license": "12846",
"primary": true
},
{
"code": "225XP0200X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Occupational Therapist, Pediatrics",
"state": "FL",
"license": "12846",
"primary": false
},
{
"code": "235Z00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Speech-Language Pathologist",
"state": "FL",
"license": "5854",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "008552700",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Edgewater, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.