Individual provider Active NPI

Alfred Charles

  • Occupational Therapist
  • Wauchula, FL
National Provider Identifier
1629435706
Registry record updated Jan 20, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
OT16428 Issued in FL
Practice address
401 Orange PL
Wauchula, FL 33873-3417
Phone
(863) 773-3231
NPI assigned
Jan 20, 2016
Last updated
Jan 20, 2016By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 20, 2016

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 OT16428 FL Primary

Addresses

Primary practice location

401 Orange PL
Wauchula, FL 33873-3417

Mailing address

16352 NW 17TH St
Pembroke Pines, FL 33028-1722

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240719001653 FL Practitioner - Occupational Therapist in Private Practice 7315483971 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Fox Rehab OT FL LLCGroup PAC ID 7810395696, 55 clinicians

Practice addresses (Care Compare)

Sarasota, FL 34238
Phone (877) 407-3422

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OT16428FLMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Fox Rehab OT FL LLC Occupational Therapist CurrentSince Jul 1, 2024 Accepting new patients

Locations

3882 Central Sarasota Pkwy
Sarasota, FL 34238
Phone (941) 282-7965

7 Carnegie Plz
Cherry Hill, NJ 08003

Organizations & group practices 1

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": "1453248000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1453248000000",
    "number": "1629435706",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16352 NW 17TH ST",
            "city": "PEMBROKE PINES",
            "state": "FL",
            "postal_code": "330281722"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 ORANGE PL",
            "city": "WAUCHULA",
            "state": "FL",
            "postal_code": "338733417",
            "telephone_number": "863-773-3231"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHARLES",
        "first_name": "ALFRED",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-01-20",
        "last_updated": "2016-01-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "FL",
            "license": "OT16428",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wauchula, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 2016; 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.