Active NPI
Jannic Richardson, OTR L
- Occupational Therapist
- Coral Springs, FL
National Provider Identifier
1487789368
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 8555
- Practice address
- 4966 Chardonnay Dr
Coral Springs, FL 33067-4121 - Phone
- (954) 234-6002
- NPI assigned
- Feb 22, 2007
- 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 Therapist | 225X00000X | 8555 | FL | Primary |
| Developmental Therapist | 222Q00000X | 8555 | FL |
Addresses
Primary practice location
4966 Chardonnay Dr
Coral Springs, FL 33067-4121
Mailing address
4966 Chardonnay Dr
Coral Springs, FL 33067-4121
Phone (954) 234-6002
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 |
|---|---|---|---|
| 8555 | FL | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1172102400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1375228800000",
"number": "1487789368",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4966 CHARDONNAY DR",
"city": "CORAL SPRINGS",
"state": "FL",
"postal_code": "330674121",
"telephone_number": "954-234-6002"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4966 CHARDONNAY DR",
"city": "CORAL SPRINGS",
"state": "FL",
"postal_code": "330674121",
"telephone_number": "954-234-6002"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RICHARDSON",
"first_name": "JANNIC",
"credential": "OTR L",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-02-22",
"last_updated": "2013-07-31",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "FL",
"license": "8555",
"primary": true
},
{
"code": "222Q00000X",
"taxonomy_group": "",
"desc": "Developmental Therapist",
"state": "FL",
"license": "8555",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Coral Springs, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.