Organization Active NPI

Occupational Wellness Solutions, Inc

  • Occupational Therapist
  • Edgewater, FL
National Provider Identifier
1407290406
Registry record updated Jul 14, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
12846 Issued in FL
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

Updated by the provider on Jul 14, 2020

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

Authorized official

Name
Gina Roberson-Johnson, OTRNPI 1750570388
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)CodeLicenseStatePrimary
Occupational Therapy AssistantGroup: 193200000X MULTI-SPECIALTY GROUP 224Z00000X 9923 FL
Physical TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225100000X 6759 FL
Pediatric Physical TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 2251P0200X 6759 FL
Physical Therapy AssistantGroup: 193200000X MULTI-SPECIALTY GROUP 225200000X 22799 FL
Occupational TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225X00000X 12846 FL Primary
Pediatric Occupational TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225XP0200X 12846 FL
Speech-Language PathologistGroup: 193200000X MULTI-SPECIALTY GROUP 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

IdentifierTypeStateIssuer
008552700MedicaidFL

National Provider Directory

National Provider Directory

Locations

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.

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.

Verify at the official NPI Registry.