Active NPI
Melissa Roffler
- Occupational Therapy Assistant
- Fernandina Beach, FL
National Provider Identifier
1538505045
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapy Assistant
- License
- OTA 10041
- Practice address
- 85186 Amagansett Dr
Fernandina Beach, FL 32034-8711 - Phone
- (904) 225-9110
- NPI assigned
- May 13, 2013
- Sex
- Female
- Sole proprietor
- Yes
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 Therapy Assistant | 224Z00000X | OTA 10041 | FL | Primary |
Addresses
Primary practice location
85186 Amagansett Dr
Fernandina Beach, FL 32034-8711
Mailing address
85186 Amagansett Dr
Fernandina Beach, FL 32034-8711
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 |
|---|---|---|---|
| OTA 10041 | FL | MD | Occupational Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1368403200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1368403200000",
"number": "1538505045",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "85186 AMAGANSETT DR",
"city": "FERNANDINA BEACH",
"state": "FL",
"postal_code": "320348711"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "85186 AMAGANSETT DR",
"city": "FERNANDINA BEACH",
"state": "FL",
"postal_code": "320348711",
"telephone_number": "904-225-9110"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROFFLER",
"first_name": "MELISSA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2013-05-13",
"last_updated": "2013-05-13",
"status": "A"
},
"taxonomies": [
{
"code": "224Z00000X",
"taxonomy_group": "",
"desc": "Occupational Therapy Assistant",
"state": "FL",
"license": "OTA 10041",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fernandina Beach, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 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.