Active NPI
Madisen Nguyen, OT
- Occupational Therapist
- Dade City, FL
National Provider Identifier
1528821246
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- OT24936
- Practice address
- 13540 17TH St
Dade City, FL 33525-5244 - Phone
- (352) 437-5151
- Fax
- (813) 212-3870
- NPI assigned
- Feb 5, 2024
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | OT24936 | FL | Primary |
Addresses
Primary practice location
13540 17TH St
Dade City, FL 33525-5244
Mailing address
2921 Chelsea Woods Dr
Valrico, FL 33596-5204
Phone (352) 232-1246
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 |
|---|---|---|---|
| OT24936 | FL | MD | Occupational Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| The Gulfside Group LLC | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1707091200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1715212800000",
"number": "1528821246",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2921 CHELSEA WOODS DR",
"city": "VALRICO",
"state": "FL",
"postal_code": "335965204",
"telephone_number": "352-232-1246",
"fax_number": "813-779-1879"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "13540 17TH ST",
"city": "DADE CITY",
"state": "FL",
"postal_code": "335255244",
"telephone_number": "352-437-5151",
"fax_number": "813-212-3870"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NGUYEN",
"first_name": "MADISEN",
"credential": "OT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-02-05",
"last_updated": "2024-05-09",
"certification_date": "2024-05-09",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "FL",
"license": "OT24936",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Dade City, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 9, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.