Individual provider Active NPI

Stephanie Holly Motilall, OTR/L , OTD

  • Occupational Therapist
  • Port Saint Lucie, FL
National Provider Identifier
1487299236
Registry record updated Nov 14, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
20429 Issued in FL
Practice address
2025 SW Trenton LN
Port Saint Lucie, FL 34984-4322
Phone
(561) 797-6001
NPI assigned
Nov 14, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 14, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 20429 FL Primary

Addresses

Primary practice location

2025 SW Trenton LN
Port Saint Lucie, FL 34984-4322

Mailing address

2025 SW Trenton LN
Port Saint Lucie, FL 34984-4322
Phone (561) 797-6001

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

State licenses

LicenseStateTypeSpecialty
20429FLMDOccupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1573689600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1573689600000",
    "number": "1487299236",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2025 SW TRENTON LN",
            "city": "PORT SAINT LUCIE",
            "state": "FL",
            "postal_code": "349844322",
            "telephone_number": "561-797-6001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2025 SW TRENTON LN",
            "city": "PORT SAINT LUCIE",
            "state": "FL",
            "postal_code": "349844322",
            "telephone_number": "561-797-6001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOTILALL",
        "first_name": "STEPHANIE",
        "middle_name": "HOLLY",
        "credential": "OTR/L , OTD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-11-14",
        "last_updated": "2019-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "FL",
            "license": "20429",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Saint Lucie, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.