Active NPI
Rochelle Craig
- Occupational Therapy Assistant
- Port Orange, FL
National Provider Identifier
1477097673
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapy Assistant
- License
- 8761
- Practice address
- 5535 S Williamson Blvd
Ste 774
Port Orange, FL 32128-8311 - Phone
- (888) 265-2680
- NPI assigned
- Dec 7, 2016
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapy Assistant | 224Z00000X | 8761 | NC | Primary |
| Occupational Therapy Assistant | 224Z00000X | 3230 | SC |
Addresses
Primary practice location
5535 S Williamson Blvd
Ste 774
Port Orange, FL 32128-8311
Mailing address
681 Rock Lake GLN
Fort Mill, SC 29715-6454
Phone (809) 389-8977
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 |
|---|---|---|---|
| 3230 | SC | MD | Endodontist |
| 8761 | NC | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1481068800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1481068800000",
"number": "1477097673",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "681 ROCK LAKE GLN",
"city": "FORT MILL",
"state": "SC",
"postal_code": "297156454",
"telephone_number": "809-389-8977"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5535 S WILLIAMSON BLVD",
"address_2": "STE 774",
"city": "PORT ORANGE",
"state": "FL",
"postal_code": "321288311",
"telephone_number": "888-265-2680"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CRAIG",
"first_name": "ROCHELLE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-12-07",
"last_updated": "2016-12-07",
"status": "A"
},
"taxonomies": [
{
"code": "224Z00000X",
"taxonomy_group": "",
"desc": "Occupational Therapy Assistant",
"state": "NC",
"license": "8761",
"primary": true
},
{
"code": "224Z00000X",
"taxonomy_group": "",
"desc": "Occupational Therapy Assistant",
"state": "SC",
"license": "3230",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Port Orange, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.