Individual provider Active NPI

Danielle Thibeault

  • Occupational Therapist
  • West Melbourne, FL
National Provider Identifier
1598238396
Registry record updated Jan 4, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
OT8117 Issued in FL
Practice address
2129 W New Haven Ave
West Melbourne, FL 32904-3875
Phone
(321) 676-8806
NPI assigned
Jan 4, 2019
Last updated
Jan 4, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 4, 2019

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 OT8117 FL Primary

Addresses

Primary practice location

2129 W New Haven Ave
West Melbourne, FL 32904-3875

Mailing address

245 Cahaba Valley Pkwy Ste 200
Pelham, AL 35124-2217
Phone (205) 942-6820

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240315001581 FL Practitioner - Occupational Therapist in Private Practice 4082050703 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Empowerme Rehabilitation Florida, LLCGroup PAC ID 3274962790, 151 clinicians

Practice addresses (Care Compare)

3400 SE Aster LN
Empowerme Rehabilitation Stuart
Stuart, FL 34994-5516
Phone (877) 367-9772

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OT8117FLMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Empowerme Rehabilitation Florida, LLC CurrentSince Mar 10, 2024 Accepting new patients
Empowerme Rehabilitation Florida, LLC CurrentSince Mar 10, 2024 Accepting new patients

Locations

6945 Carlisle Ct
Naples, FL 34109
Phone (239) 249-6877

1335 Strassner Dr
Saint Louis, MO 63144
Phone (314) 287-3917

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": "1546560000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1546560000000",
    "number": "1598238396",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "245 CAHABA VALLEY PKWY STE 200",
            "city": "PELHAM",
            "state": "AL",
            "postal_code": "351242217",
            "telephone_number": "205-942-6820"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2129 W NEW HAVEN AVE",
            "city": "WEST MELBOURNE",
            "state": "FL",
            "postal_code": "329043875",
            "telephone_number": "321-676-8806"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THIBEAULT",
        "first_name": "DANIELLE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-01-04",
        "last_updated": "2019-01-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "FL",
            "license": "OT8117",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Melbourne, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2019; 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.