Emily Grant, COTA/L

Key facts

NPI

1508435876

Entity type

Individual (NPI type 1)

Primary specialty

Occupational Therapy Assistant 224Z00000X

License

OTA17066 (FL)

Practice address

401 Judson Dr
Perry, FL 32348-4768

Phone

(850) 843-1656

NPI assigned

Jun 22, 2021

Sex

Female

Sole proprietor

No

Medicare participation

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)

No

State licenses

Specialties & licenses

Addresses

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Jun 22, 2021.

{
    "created_epoch": "1624320000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624320000000",
    "number": "1508435876",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401 JUDSON DR",
            "city": "PERRY",
            "state": "FL",
            "postal_code": "323484768",
            "telephone_number": "850-843-1656"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 JUDSON DR",
            "city": "PERRY",
            "state": "FL",
            "postal_code": "323484768",
            "telephone_number": "850-843-1656"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRANT",
        "first_name": "EMILY",
        "credential": "COTA/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-06-22",
        "last_updated": "2021-06-22",
        "certification_date": "2021-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "FL",
            "license": "OTA17066",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Rachel Gilliam
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• Jeremy Lee Gray, P.T.
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• Lori Gulbrandsen
• Firas A Hamdan, MD PA
• Tori Hampton

All providers in Perry, FL · Occupational Therapy Assistant in Florida