Individual provider Active NPI

Stephanie Annq Fueyo, LOT

  • Occupational Therapist
  • Gainesville, FL
National Provider Identifier
1417228065
Registry record updated Jan 13, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
OT9845 Issued in FL
Practice address
6700 NW 10TH PL
Gainesville, FL 32605-4213
Phone
(352) 331-6280
NPI assigned
Jan 13, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 13, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X OT9845 FL Primary

Addresses

Primary practice location

6700 NW 10TH PL
Gainesville, FL 32605-4213

Mailing address

6700 NW 10TH PL
Gainesville, FL 32605-4213
Phone (352) 331-6280

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20211026003274 FL Practitioner - Occupational Therapist in Private Practice 3476941394 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OT9845FLMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Powerback Rehabilitation LLC Occupational Therapist CurrentSince Jun 22, 2025 Accepting new patients
Powerback Rehabilitation LLC Occupational Therapist CurrentSince Jun 22, 2025 Accepting new patients
Rehabcare Group East, LLC Past Accepting new patients

Locations

3450 Wimbledon Dr
Pensacola, FL 32504
Phone (850) 434-3232

910 Regency Sq
Vero Beach, FL 32967
Phone (772) 213-0423

101 E State St
Kennett Square, PA 19348
Phone (610) 925-4436

Organizations & group practices 3

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": "1326412800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1326412800000",
    "number": "1417228065",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6700 NW 10TH PL",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326054213",
            "telephone_number": "352-331-6280"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6700 NW 10TH PL",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326054213",
            "telephone_number": "352-331-6280"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FUEYO",
        "first_name": "STEPHANIE",
        "middle_name": "ANNQ",
        "name_prefix": "Ms.",
        "credential": "LOT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-01-13",
        "last_updated": "2012-01-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "FL",
            "license": "OT9845",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gainesville, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.