Active NPI
Marshell Previlor, OTA/L
- Occupational Therapy Assistant
- North Lauderdale, FL
National Provider Identifier
1437896032
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapy Assistant
- License
- OTA12511
- Practice address
- 6047 Kimberly Blvd Ste U
North Lauderdale, FL 33068-2820 - Phone
- (954) 876-1249
- NPI assigned
- May 16, 2022
- Last updated
- Aug 1, 2022
- 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 Therapy Assistant | 224Z00000X | OTA12511 | FL | Primary |
Addresses
Primary practice location
6047 Kimberly Blvd Ste U
North Lauderdale, FL 33068-2820
Mailing address
1704 Katherine CT
Lake Worth, FL 33461-6107
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 |
|---|---|---|---|
| OTA12511 | FL | MD | Occupational Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1652659200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1659312000000",
"number": "1437896032",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1704 KATHERINE CT",
"city": "LAKE WORTH",
"state": "FL",
"postal_code": "334616107"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6047 KIMBERLY BLVD STE U",
"city": "NORTH LAUDERDALE",
"state": "FL",
"postal_code": "330682820",
"telephone_number": "954-876-1249"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PREVILOR",
"first_name": "MARSHELL",
"credential": "OTA/L",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2022-05-16",
"last_updated": "2022-08-01",
"certification_date": "2022-08-01",
"status": "A"
},
"taxonomies": [
{
"code": "224Z00000X",
"taxonomy_group": "",
"desc": "Occupational Therapy Assistant",
"state": "FL",
"license": "OTA12511",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in North Lauderdale, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.