Individual provider Active NPI

Gary Robinson, OTR, CHT, MBA

  • Occupational Therapist
  • Daytona Beach, FL
National Provider Identifier
1558486076
Registry record updated Aug 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
OT20223 Issued in FL
Practice address
1865 Lpga Blvd
Daytona Beach, FL 32117-7108
Phone
(386) 255-4596
Fax
(386) 257-0558
NPI assigned
Mar 21, 2007
Last updated
Aug 2, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 2, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 3807 TN
Occupational Therapist 225X00000X OT20223 FL Primary

Addresses

Primary practice location

1865 Lpga Blvd
Daytona Beach, FL 32117-7108

Mailing address

1865 Lpga Blvd
Daytona Beach, FL 32117-7108
Phone (386) 255-4596

Other practice location 1

324 Cool Springs Blvd
Franklin, TN 37067-1631
Phone (615) 791-7257

Other identifiers 1

IdentifierTypeStateIssuer
119953500MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230930000496 FL Practitioner - Occupational Therapist in Private Practice 8224117221 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1890 Lpga Blvd
Suite 240
Daytona Beach, FL 32117-7131
Phone (386) 255-4596

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Business Administration

State licenses

LicenseStateTypeSpecialty
OT20223FLMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Orthopaedic Clinic of Daytona Beach PA CurrentSince Oct 9, 2023 Accepting new patients
Orthopaedic Clinic of Daytona Beach PA CurrentSince Oct 9, 2023 Accepting new patients

Locations

1075 Mason Ave
Daytona Beach, FL 32117
Phone (386) 255-4596

1865 Lpga Blvd
Daytona Beach, FL 32117
Phone (386) 255-4596

1890 Lpga Blvd
Ste 240
Daytona Beach, FL 32117
Phone (386) 255-4596

17 Old Kings Rd N
Ste K
Palm Coast, FL 32137
Phone (386) 255-4596

1165 Dunlawton Ave
Ste 102
Port Orange, FL 32127
Phone (386) 255-4596

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/10735/brand/1/csg/1/fhir/r4

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1174435200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722556800000",
    "number": "1558486076",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1865 LPGA BLVD",
            "city": "DAYTONA BEACH",
            "state": "FL",
            "postal_code": "321177108",
            "telephone_number": "386-255-4596",
            "fax_number": "386-257-0558"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1865 LPGA BLVD",
            "city": "DAYTONA BEACH",
            "state": "FL",
            "postal_code": "321177108",
            "telephone_number": "386-255-4596",
            "fax_number": "386-257-0558"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "324 Cool Springs Blvd",
            "address_purpose": "LOCATION",
            "city": "Franklin",
            "state": "TN",
            "postal_code": "370671631",
            "country_code": "US",
            "telephone_number": "615-791-7257",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROBINSON",
        "first_name": "GARY",
        "name_prefix": "Mr.",
        "credential": "OTR, CHT, MBA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-21",
        "last_updated": "2024-08-02",
        "certification_date": "2024-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "TN",
            "license": "3807",
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "FL",
            "license": "OT20223",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "119953500",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Daytona Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.