Individual provider Active NPI

Charmaine Rose Lewis, COTA

  • Occupational Therapy Assistant
  • Coral Springs, FL
National Provider Identifier
1497046593
Registry record updated Apr 22, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Therapy AssistantTaxonomy code 224Z00000X
License
11022 Issued in FL
Practice address
5830 Coral Ridge Dr
Suite #120
Coral Springs, FL 33076-3392
Phone
(954) 752-6065
Fax
(954) 752-5746
NPI assigned
Apr 22, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 22, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy Assistant 224Z00000X 11022 FL Primary
Occupational Therapy Assistant 224Z00000X 210594 TX

Addresses

Primary practice location

5830 Coral Ridge Dr
Suite #120
Coral Springs, FL 33076-3392

Mailing address

11260 NW 41St CT
Coral Springs, FL 33065-7764
Phone (954) 822-9560

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

LicenseStateTypeSpecialty
11022FLMDOccupational Therapy Assistant
210594TXMDOccupational Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1303430400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1303430400000",
    "number": "1497046593",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11260 NW 41ST CT",
            "city": "CORAL SPRINGS",
            "state": "FL",
            "postal_code": "330657764",
            "telephone_number": "954-822-9560"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5830 CORAL RIDGE DR",
            "address_2": "SUITE #120",
            "city": "CORAL SPRINGS",
            "state": "FL",
            "postal_code": "330763392",
            "telephone_number": "954-752-6065",
            "fax_number": "954-752-5746"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEWIS",
        "first_name": "CHARMAINE",
        "middle_name": "ROSE",
        "credential": "COTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-04-22",
        "last_updated": "2011-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "FL",
            "license": "11022",
            "primary": true
        },
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "TX",
            "license": "210594",
            "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 Apr 22, 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.