Active NPI
Nicole Falkenstein
- Pediatric Occupational Therapist
- Fort Walton Beach, FL
National Provider Identifier
1407311558
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Occupational Therapist
- License
- OT19768
- Practice address
- 220 Eglin Pkwy SE
Fort Walton Beach, FL 32548-5899 - Phone
- (850) 200-4348
- NPI assigned
- Feb 3, 2019
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Pediatric Occupational Therapist | 225XP0200X | OT19768 | FL | Primary |
Addresses
Primary practice location
220 Eglin Pkwy SE
Fort Walton Beach, FL 32548-5899
Mailing address
1715 Driftwood Point Rd
Santa Rosa Beach, FL 32459-3032
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 |
|---|---|---|---|
| OT19768 | FL | MD | Pediatric Occupational Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Kidz Korner | Pediatrics | 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 and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1549152000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1549152000000",
"number": "1407311558",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1715 DRIFTWOOD POINT RD",
"city": "SANTA ROSA BEACH",
"state": "FL",
"postal_code": "324593032"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "220 EGLIN PKWY SE",
"city": "FORT WALTON BEACH",
"state": "FL",
"postal_code": "325485899",
"telephone_number": "850-200-4348"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FALKENSTEIN",
"first_name": "NICOLE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-02-03",
"last_updated": "2019-02-03",
"status": "A"
},
"taxonomies": [
{
"code": "225XP0200X",
"taxonomy_group": "",
"desc": "Occupational Therapist, Pediatrics",
"state": "FL",
"license": "OT19768",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Fort Walton Beach, FL
- Eye Candy Optical LLC
- Eyeglass World
- Amanda Bernadette Eyer, MSN, ARNP FNP-C
- Edith Selden Ezell, OTR/L
- Phillip Falasca, CRNA
- Family & Child Development of Northwest Florida, Inc.
- Family and Child Development
- Family Life Ministries of NW Florida
- Family Medicine Associates of the Emerald Coast P a
- Heather Farmer
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.