Individual provider Active NPI

Ada Keung Lombardo, OTR

  • Occupational Therapist
  • Port Charlotte, FL
National Provider Identifier
1558071209
Registry record updated Dec 2, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
OT3103 Issued in FL
Practice address
23013 Westchester Blvd
Port Charlotte, FL 33980-8448
Phone
(941) 625-1100
Fax
(941) 613-0058
NPI assigned
Dec 2, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 2, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X OT3103 FL Primary

Addresses

Primary practice location

23013 Westchester Blvd
Port Charlotte, FL 33980-8448

Mailing address

23013 Westchester Blvd
Port Charlotte, FL 33980-8448
Phone (941) 625-1100

Electronic endpoints 1

TypeEndpointUseAffiliation
FHIR URL 941-6260579 Direct

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
OT3103FLMDOccupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1669939200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1669939200000",
    "number": "1558071209",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23013 WESTCHESTER BLVD",
            "city": "PORT CHARLOTTE",
            "state": "FL",
            "postal_code": "339808448",
            "telephone_number": "941-625-1100",
            "fax_number": "941-613-0058"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23013 WESTCHESTER BLVD",
            "city": "PORT CHARLOTTE",
            "state": "FL",
            "postal_code": "339808448",
            "telephone_number": "941-625-1100",
            "fax_number": "941-613-0058"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOMBARDO",
        "first_name": "ADA",
        "middle_name": "KEUNG",
        "credential": "OTR",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-12-02",
        "last_updated": "2022-12-02",
        "certification_date": "2022-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "FL",
            "license": "OT3103",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "941-6260579",
            "affiliation": "N",
            "endpointDescription": "cell phone",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "3690 Como St",
            "city": "Port Charlotte",
            "state": "FL",
            "country_code": "US",
            "postal_code": "339481776",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Port Charlotte, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2022; 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.