NPIMap

Organization Active NPI

Lifeforce Pediatric Therapy

  • Occupational Therapist
  • Port Saint Lucie, FL
National Provider Identifier
1457789596
Registry record updated Oct 29, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
12838 Issued in FL
Legal business name
LIFEFORCE PEDIATRIC THERAPY
Practice address
337 SW Cherryhill Rd
Port Saint Lucie, FL 34953-6235
Phone
(586) 206-0837
NPI assigned
Oct 29, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 29, 2013

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

Authorized official

Name
Ms. Shirley A Esse, M.H.M, O.T.R./LNPI 1417258021
Title
President
Phone
(586) 206-0837

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational TherapistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 225X00000X 12838 FL Primary
Occupational TherapistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 225X00000X 5201004005 MI

Addresses

Primary practice location

337 SW Cherryhill Rd
Port Saint Lucie, FL 34953-6235

Mailing address

337 SW Cherryhill Rd
Port Saint Lucie, FL 34953-6235
Phone (586) 206-0837

Other identifiers 1

IdentifierTypeStateIssuer
1417258021MedicaidFL

National Provider Directory

National Provider Directory

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": "1383004800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1383004800000",
    "number": "1457789596",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "337 SW CHERRYHILL RD",
            "city": "PORT SAINT LUCIE",
            "state": "FL",
            "postal_code": "349536235",
            "telephone_number": "586-206-0837"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "337 SW CHERRYHILL RD",
            "city": "PORT SAINT LUCIE",
            "state": "FL",
            "postal_code": "349536235",
            "telephone_number": "586-206-0837"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFEFORCE PEDIATRIC THERAPY",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-10-29",
        "last_updated": "2013-10-29",
        "status": "A",
        "authorized_official_last_name": "ESSE",
        "authorized_official_first_name": "SHIRLEY",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "586-206-0837",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "M.H.M, O.T.R./L"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Occupational Therapist",
            "state": "FL",
            "license": "12838",
            "primary": true
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Occupational Therapist",
            "state": "MI",
            "license": "5201004005",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1417258021",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Saint Lucie, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2013; 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.