NPIMap

Organization Active NPI

Pediatric Therapy Group

  • Pediatric Occupational Therapist
  • Bradenton, FL
National Provider Identifier
1497023790
Registry record updated Dec 1, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Occupational TherapistTaxonomy code 225XP0200X
License
OTA11922 Issued in FL
Legal business name
PEDIATRIC THERAPY GROUP
Practice address
4440B 26TH St W
Bradenton, FL 34207-1201
Phone
(941) 752-0408
Fax
(941) 870-0876
NPI assigned
Dec 1, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 1, 2011

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

Authorized official

Name
Mr. Stephen Martin Pickett
Title
Administrator
Phone
(941) 752-0408

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Occupational TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225XP0200X OTA11922 FL Primary

Addresses

Primary practice location

4440B 26TH St W
Bradenton, FL 34207-1201

Mailing address

4440B 26TH St W
Bradenton, FL 34207-1201
Phone (941) 752-0408

Other identifiers 1

IdentifierTypeStateIssuer
890133300MedicaidFL

National Provider Directory

National Provider Directory
Tax ID family
Martin Pickett2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1322697600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1322697600000",
    "number": "1497023790",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4440B 26TH ST W",
            "city": "BRADENTON",
            "state": "FL",
            "postal_code": "342071201",
            "telephone_number": "941-752-0408",
            "fax_number": "941-870-0876"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4440B 26TH ST W",
            "city": "BRADENTON",
            "state": "FL",
            "postal_code": "342071201",
            "telephone_number": "941-752-0408",
            "fax_number": "941-870-0876"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEDIATRIC THERAPY GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-12-01",
        "last_updated": "2011-12-01",
        "status": "A",
        "authorized_official_last_name": "PICKETT",
        "authorized_official_first_name": "STEPHEN",
        "authorized_official_middle_name": "MARTIN",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "941-752-0408",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "225XP0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "FL",
            "license": "OTA11922",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "890133300",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bradenton, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2011; 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.