Active NPI
Michelle R. Brackett, COTA
- Occupational Therapy Assistant
- Niceville, FL
National Provider Identifier
1467719153
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapy Assistant
- License
- 16181
- Practice address
- 4436 Colleen CV
Niceville, FL 32578-2467 - Phone
- (757) 270-0227
- NPI assigned
- Apr 18, 2012
- 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 | 16181 | FL | Primary |
Addresses
Primary practice location
4436 Colleen CV
Niceville, FL 32578-2467
Mailing address
4436 Colleen CV
Niceville, FL 32578-2467
Phone (757) 270-0227
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 |
|---|---|---|---|
| 16181 | FL | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1334707200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1757808000000",
"number": "1467719153",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4436 COLLEEN CV",
"city": "NICEVILLE",
"state": "FL",
"postal_code": "325782467",
"telephone_number": "757-270-0227"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4436 COLLEEN CV",
"city": "NICEVILLE",
"state": "FL",
"postal_code": "325782467",
"telephone_number": "757-270-0227"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BRACKETT",
"first_name": "MICHELLE",
"middle_name": "R.",
"name_prefix": "Ms.",
"credential": "COTA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2012-04-18",
"last_updated": "2025-09-14",
"certification_date": "2025-09-14",
"status": "A"
},
"taxonomies": [
{
"code": "224Z00000X",
"taxonomy_group": "",
"desc": "Occupational Therapy Assistant",
"state": "FL",
"license": "16181",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Niceville, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.