Individual provider Active NPI

Kristin Anne Fredmonsky, OTR/L

  • Occupational Therapist
  • Fort Walton Beach, FL
National Provider Identifier
1629369509
Registry record updated Apr 26, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
OT 14520 Issued in FL
Practice address
224D Eglin Pkwy NE
Fort Walton Beach, FL 32547-2877
Phone
(850) 862-7227
Fax
(850) 862-2421
NPI assigned
Apr 26, 2011
Last updated
Apr 26, 2011By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 26, 2011

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 OT 14520 FL Primary

Addresses

Primary practice location

224D Eglin Pkwy NE
Fort Walton Beach, FL 32547-2877

Mailing address

224D Eglin Pkwy NE
Fort Walton Beach, FL 32547-2877
Phone (850) 862-7227

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

LicenseStateTypeSpecialty
OT 14520FLMDOccupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1303776000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1303776000000",
    "number": "1629369509",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "224D EGLIN PKWY NE",
            "city": "FORT WALTON BEACH",
            "state": "FL",
            "postal_code": "325472877",
            "telephone_number": "850-862-7227",
            "fax_number": "850-862-2421"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "224D EGLIN PKWY NE",
            "city": "FORT WALTON BEACH",
            "state": "FL",
            "postal_code": "325472877",
            "telephone_number": "850-862-7227",
            "fax_number": "850-862-2421"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FREDMONSKY",
        "first_name": "KRISTIN",
        "middle_name": "ANNE",
        "name_prefix": "Mrs.",
        "credential": "OTR/L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-04-26",
        "last_updated": "2011-04-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "FL",
            "license": "OT 14520",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Walton Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 26, 2011; 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.