Andy Ananda

Primary specialty

Occupational Therapy AssistantTaxonomy code 224Z00000X

License

204596 Issued in TX

Practice address

5535 S Williamson Blvd
Ste 774
Port Orange, FL 32128-8311

Phone

(866) 330-7711

NPI assigned

Mar 15, 2012

Last updated

Mar 15, 2012By the provider in NPPES

Sex

Male

Sole proprietor

No

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": "1331769600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1331769600000",
    "number": "1609141241",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "911 STERLING LN",
            "city": "CROWLEY",
            "state": "TX",
            "postal_code": "760364626"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5535 S WILLIAMSON BLVD",
            "address_2": "STE 774",
            "city": "PORT ORANGE",
            "state": "FL",
            "postal_code": "321288311",
            "telephone_number": "866-330-7711"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANANDA",
        "first_name": "ANDY",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-03-15",
        "last_updated": "2012-03-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "TX",
            "license": "204596",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Edgar Leopold Anderson, R.N.

• Occupational Therapy Assistant in Port Orange, FL
• Providers in Port Orange, FL by specialty
• Occupational Therapy Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 2012; 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.