Active NPI
Amelia Mullenix-Jones
- Occupational Therapist
- Gulf Breeze, FL
National Provider Identifier
1619569878
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- OTA17816
- Practice address
- 5612 Monument CT
Gulf Breeze, FL 32563-9634 - Phone
- (937) 287-5605
- NPI assigned
- Feb 9, 2021
- 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 Therapist | 225X00000X | OTA17816 | FL | Primary |
Addresses
Primary practice location
5612 Monument CT
Gulf Breeze, FL 32563-9634
Mailing address
5612 Monument CT
Gulf Breeze, FL 32563-9634
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| OTA17816 | FL | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1612828800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1612828800000",
"number": "1619569878",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5612 MONUMENT CT",
"city": "GULF BREEZE",
"state": "FL",
"postal_code": "325639634"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5612 MONUMENT CT",
"city": "GULF BREEZE",
"state": "FL",
"postal_code": "325639634",
"telephone_number": "937-287-5605"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MULLENIX-JONES",
"first_name": "AMELIA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2021-02-09",
"last_updated": "2021-02-09",
"certification_date": "2021-02-09",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "FL",
"license": "OTA17816",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Gulf Breeze, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.