Active NPI
Nickolas Hetherington, OTR/L
- Occupational Therapist
- Melbourne, FL
National Provider Identifier
1467804278
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- OT17856
- Practice address
- 1900 S Harbor City Blvd Ste 108
Melbourne, FL 32901 - Phone
- (833) 684-5439
- Fax
- (321) 684-5439
- NPI assigned
- Jul 5, 2016
- Sex
- Male
- 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 Therapist | 225X00000X | OT17856 | FL | Primary |
Addresses
Primary practice location
1900 S Harbor City Blvd Ste 108
Melbourne, FL 32901
Mailing address
868 Westport Dr
Rockledge, FL 32955-3566
Phone (833) 684-5439
Other practice location 1
1800 Penn St
Suite 12
Melbourne, FL 32901-2643
Phone (321) 768-6800
Other practice location 2
1634 Saladino St SE
Palm Bay, FL 32909-5425
Phone (833) 684-5439
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
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| HT 2.0 Pediatric Therapy PLLC | Occupational Therapist | Current | Accepting new patients |
| Hetherington Therapy | Occupational Therapist | Current | Accepting new patients |
Organizations & group practices 2
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.
-
- Speech-Language Pathologist
- Melbourne, FL
- NPI 1164231718
Occupational Therapist
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1467676800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1542326400000",
"number": "1467804278",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "868 WESTPORT DR",
"city": "ROCKLEDGE",
"state": "FL",
"postal_code": "329553566",
"telephone_number": "833-684-5439",
"fax_number": "321-286-3020"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1900 S HARBOR CITY BLVD STE 108",
"city": "MELBOURNE",
"state": "FL",
"postal_code": "32901",
"telephone_number": "833-684-5439",
"fax_number": "321-684-5439"
}
],
"practiceLocations": [
{
"address_1": "1800 Penn St",
"address_2": "Suite 12",
"address_purpose": "LOCATION",
"city": "Melbourne",
"state": "FL",
"postal_code": "329012643",
"country_code": "US",
"telephone_number": "321-768-6800",
"fax_number": "321-768-6858",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "1634 Saladino St SE",
"address_purpose": "LOCATION",
"city": "Palm Bay",
"state": "FL",
"postal_code": "329095425",
"country_code": "US",
"telephone_number": "833-684-5439",
"fax_number": "321-286-3020",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "HETHERINGTON",
"first_name": "NICKOLAS",
"credential": "OTR/L",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2016-07-05",
"last_updated": "2018-11-16",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "FL",
"license": "OT17856",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Melbourne, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.