Active NPI
Kristine Frances Rodriguez, COTA/L
- Occupational Therapy Assistant
- Palm Coast, FL
National Provider Identifier
1467831313
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapy Assistant
- License
- OTA 14459
- Practice address
- 16 Fernmill LN
Palm Coast, FL 32137-9104 - Phone
- (386) 503-0921
- NPI assigned
- May 26, 2015
- Sex
- Female
- Sole proprietor
- No
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 | OTA 14459 | FL | Primary |
Addresses
Primary practice location
16 Fernmill LN
Palm Coast, FL 32137-9104
Mailing address
16 Fernmill LN
Palm Coast, FL 32137-9104
Phone (386) 503-0921
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 81063086701 | Other | FL | MED IMPACT |
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 |
|---|---|---|---|
| OTA 14459 | FL | MD | Occupational Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1432598400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1432598400000",
"number": "1467831313",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "16 FERNMILL LN",
"city": "PALM COAST",
"state": "FL",
"postal_code": "321379104",
"telephone_number": "386-503-0921"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "16 FERNMILL LN",
"city": "PALM COAST",
"state": "FL",
"postal_code": "321379104",
"telephone_number": "386-503-0921"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RODRIGUEZ",
"first_name": "KRISTINE",
"middle_name": "FRANCES",
"credential": "COTA/L",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-05-26",
"last_updated": "2015-05-26",
"status": "A"
},
"taxonomies": [
{
"code": "224Z00000X",
"taxonomy_group": "",
"desc": "Occupational Therapy Assistant",
"state": "FL",
"license": "OTA 14459",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MED IMPACT",
"identifier": "81063086701",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Palm Coast, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 26, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.