Individual provider Active NPI

Theresa Benefield

  • Occupational Therapy Assistant
  • Valrico, FL
National Provider Identifier
1538579388
Registry record updated May 2, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Therapy AssistantTaxonomy code 224Z00000X
License
OTA 11455 Issued in FL
Practice address
5323 Cottonwood Tree Cir
Valrico, FL 33596-8258
Phone
(813) 655-9468
NPI assigned
May 2, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 2, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy Assistant 224Z00000X OTA 11455 FL Primary

Addresses

Primary practice location

5323 Cottonwood Tree Cir
Valrico, FL 33596-8258

Mailing address

5323 Cottonwood Tree Cir
Valrico, FL 33596-8258
Phone (813) 655-9468

Other identifiers 1

IdentifierTypeStateIssuer
OTA 11455OtherFLSTATE OF FLORIDA DEPARTMENT OF HEALTH

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
OTA 11455FLMDOccupational Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1398988800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1398988800000",
    "number": "1538579388",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5323 COTTONWOOD TREE CIR",
            "city": "VALRICO",
            "state": "FL",
            "postal_code": "335968258",
            "telephone_number": "813-655-9468"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5323 COTTONWOOD TREE CIR",
            "city": "VALRICO",
            "state": "FL",
            "postal_code": "335968258",
            "telephone_number": "813-655-9468"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENEFIELD",
        "first_name": "THERESA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-05-02",
        "last_updated": "2014-05-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "FL",
            "license": "OTA 11455",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE OF FLORIDA DEPARTMENT OF HEALTH",
            "identifier": "OTA 11455",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Valrico, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 2014; 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.