Luke Jared Retherford, OTR/L

Primary specialty

Physical Rehabilitation Occupational TherapistTaxonomy code 225XP0019X

License

13677 Issued in FL

Practice address

1690 US Highway 1 S
Saint Augustine, FL 32084-4192

Phone

(904) 810-2101

NPI assigned

Aug 16, 2009

Last updated

Aug 16, 2009By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1250380800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1250380800000",
    "number": "1558593194",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3015 AQUA VISTA LN APT 111",
            "city": "SAINT AUGUSTINE",
            "state": "FL",
            "postal_code": "320841262",
            "telephone_number": "256-436-3746"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1690 US HIGHWAY 1 S",
            "city": "SAINT AUGUSTINE",
            "state": "FL",
            "postal_code": "320844192",
            "telephone_number": "904-810-2101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RETHERFORD",
        "first_name": "LUKE",
        "middle_name": "JARED",
        "credential": "OTR/L",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-08-16",
        "last_updated": "2009-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XP0019X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Physical Rehabilitation",
            "state": "FL",
            "license": "13677",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Physical Rehabilitation Occupational Therapist in St Augustine, FL
• Providers in St Augustine, FL by specialty
• Physical Rehabilitation Occupational Therapist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2009; 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.