Active NPI
Magda Jerome
- Occupational Therapy Assistant
- Kissimmee, FL
National Provider Identifier
1619095502
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapy Assistant
- License
- OTA9789
- Practice address
- 2511 N John Young Pkwy
Kissimmee, FL 34741-1653 - Phone
- (321) 443-1333
- NPI assigned
- Mar 27, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapy Assistant | 224Z00000X | OTA9789 | FL | Primary |
Addresses
Primary practice location
2511 N John Young Pkwy
Kissimmee, FL 34741-1653
Mailing address
2511 N John Young Pkwy
Kissimmee, FL 34741-1653
Phone (321) 443-1333
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 888257600 | Medicaid | FL |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| OTA9789 | FL | MD | Occupational Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1174953600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1360886400000",
"number": "1619095502",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2511 N JOHN YOUNG PKWY",
"city": "KISSIMMEE",
"state": "FL",
"postal_code": "347411653",
"telephone_number": "321-443-1333"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2511 N JOHN YOUNG PKWY",
"city": "KISSIMMEE",
"state": "FL",
"postal_code": "347411653",
"telephone_number": "321-443-1333"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JEROME",
"first_name": "MAGDA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-03-27",
"last_updated": "2013-02-15",
"status": "A"
},
"taxonomies": [
{
"code": "224Z00000X",
"taxonomy_group": "",
"desc": "Occupational Therapy Assistant",
"state": "FL",
"license": "OTA9789",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "888257600",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Kissimmee, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.