Individual provider Active NPI

Maire Archbold, OTR/L

  • Occupational Therapist
  • St Petersburg, FL
National Provider Identifier
1447285044
Registry record updated Apr 11, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
OT3198 Issued in FL
Practice address
4401 14TH Ave N
St Petersburg, FL 33713-5225
Phone
(727) 327-3868
Fax
(727) 327-3868
NPI assigned
Jul 11, 2006
Last updated
Apr 11, 2011By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 11, 2011

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Massage Therapist 225700000X MA29461 FL
Occupational Therapist 225X00000X OT3198 FL Primary
Human Factors Occupational Therapist 225XH1300X OT3198 FL

Addresses

Primary practice location

4401 14TH Ave N
St Petersburg, FL 33713-5225

Mailing address

4401 14TH Ave N
St Petersburg, FL 33713-5225
Phone (727) 327-3868

Other identifiers 1

IdentifierTypeStateIssuer
888349100MedicaidFL

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
MA29461FLMDMassage Therapist
OT3198FLMDHuman Factors Occupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
All-Star Therapy, Inc 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1152576000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1302480000000",
    "number": "1447285044",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4401 14TH AVE N",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337135225",
            "telephone_number": "727-327-3868",
            "fax_number": "727-327-3868"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4401 14TH AVE N",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337135225",
            "telephone_number": "727-327-3868",
            "fax_number": "727-327-3868"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ARCHBOLD",
        "first_name": "MAIRE",
        "credential": "OTR/L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-11",
        "last_updated": "2011-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "FL",
            "license": "MA29461",
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "FL",
            "license": "OT3198",
            "primary": true
        },
        {
            "code": "225XH1300X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Human Factors",
            "state": "FL",
            "license": "OT3198",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "888349100",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in St Petersburg, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2011; 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.