Immersed Pediatric Therapy LLC

Primary specialty

Pediatric Occupational TherapistTaxonomy code 225XP0200X

Legal business name

IMMERSED PEDIATRIC THERAPY LLC

Practice address

6915 Surrey Oak Dr
Apollo Beach, FL 33572-1531

Phone

(813) 400-3265

NPI assigned

Jan 25, 2023

Organization subpart

No

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

Authorized official

Name

Aja Perry, MS, ORT/LNPI 1881359743

Title

Occupational Therapist

Phone

(904) 304-0434

Specialties & licenses 2

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Aja Perry, OTR/L

  • Occupational Therapist
  • Manchester, GA
  • NPI 1881359743
  NPD Authorized official

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

{
    "created_epoch": "1674604800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1674604800000",
    "number": "1558077370",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2424 W BRANDON BLVD # 1023",
            "city": "BRANDON",
            "state": "FL",
            "postal_code": "335114717",
            "telephone_number": "813-400-3265"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6915 SURREY OAK DR",
            "city": "APOLLO BEACH",
            "state": "FL",
            "postal_code": "335721531",
            "telephone_number": "813-400-3265"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IMMERSED PEDIATRIC THERAPY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-01-25",
        "last_updated": "2023-01-25",
        "certification_date": "2023-01-25",
        "status": "A",
        "authorized_official_last_name": "PERRY",
        "authorized_official_first_name": "AJA",
        "authorized_official_title_or_position": "OCCUPATIONAL THERAPIST",
        "authorized_official_telephone_number": "904-304-0434",
        "authorized_official_credential": "MS, ORT/L"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225XP0200X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Occupational Therapist, Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Pediatric Occupational Therapist in Apollo Beach, FL
• Providers in Apollo Beach, FL by specialty
• Pediatric Occupational Therapist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2023; 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.