Kassondra L Macy, OT

Primary specialty

Pediatric Occupational TherapistTaxonomy code 225XP0200X

License

OT11580 Issued in FL

Practice address

17835 Murdock Cir
Port Charlotte, FL 33948-4000

Phone

(941) 625-6547

Fax

(941) 629-6415

NPI assigned

Sep 27, 2005

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Legacy Healthcare Services, Inc

  • Physical Therapist
  • Tampa, FL
  • NPI 1336535988
  Medicare reassignment NPD
• Legacy Healthcare Services Inc

  • Physical Therapist
  • Cary, NC
  • NPI 1225879489
  NPD

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

{
    "created_epoch": "1127779200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1467448258",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17835 MURDOCK CIR",
            "city": "PORT CHARLOTTE",
            "state": "FL",
            "postal_code": "339484000",
            "telephone_number": "941-625-6547",
            "fax_number": "941-629-6415"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17835 MURDOCK CIR",
            "city": "PORT CHARLOTTE",
            "state": "FL",
            "postal_code": "339484000",
            "telephone_number": "941-625-6547",
            "fax_number": "941-629-6415"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MACY",
        "first_name": "KASSONDRA",
        "middle_name": "L",
        "name_prefix": "Mrs.",
        "credential": "OT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-09-27",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "FL",
            "license": "OT11580",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS",
            "identifier": "Z076F",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Craig Macarthur, M.D.
• Kathleen Macdougall, LICSW
• Christine Macedo Garcia
• Sandra M Macsweeney, FNP-C, PMHNP-C
• Michael J Macuga, MD
• Arelis Margarita Madera, MD
• Karen Ann Magerko, M.A., CCC-SLP
• Larry Louis Maggiore, D.D.S.
• Rhiannon L Maggiore, O.D.
• Shantal Maher, ARNP

• Pediatric Occupational Therapist in Port Charlotte, FL
• Providers in Port Charlotte, FL by specialty
• Pediatric Occupational Therapist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.