NPIMap

Organization Active NPI

Close the Gap Therapy Solutions, LLC

  • Occupational Therapist
  • Jacksonville, FL
National Provider Identifier
1629557616
Registry record updated Mar 4, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
OT13759 Issued in FL
Legal business name
CLOSE THE GAP THERAPY SOLUTIONS, LLC
Practice address
2640 Scott Mill Dr
Jacksonville, FL 32223-6542
Phone
(904) 304-3902
Fax
(904) 880-8047
NPI assigned
Aug 9, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 4, 2019

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mrs. Beth Anne Kelley, OTR/LNPI 1740517796
Title
Occupational Therapist/ Owner
Phone
(904) 304-3902

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225X00000X OT13759 FL Primary
Speech-Language PathologistGroup: 193200000X MULTI-SPECIALTY GROUP 235Z00000X FL

Addresses

Primary practice location

2640 Scott Mill Dr
Jacksonville, FL 32223-6542

Mailing address

2640 Scott Mill Dr
Jacksonville, FL 32223-6542
Phone (904) 304-3902

Other identifiers 1

IdentifierTypeStateIssuer
001583700MedicaidFL

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1533772800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1551657600000",
    "number": "1629557616",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2640 SCOTT MILL DR",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322236542",
            "telephone_number": "904-304-3902",
            "fax_number": "904-880-8047"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2640 SCOTT MILL DR",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322236542",
            "telephone_number": "904-304-3902",
            "fax_number": "904-880-8047"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLOSE THE GAP THERAPY SOLUTIONS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-08-09",
        "last_updated": "2019-03-04",
        "status": "A",
        "authorized_official_last_name": "KELLEY",
        "authorized_official_first_name": "BETH",
        "authorized_official_middle_name": "ANNE",
        "authorized_official_title_or_position": "OCCUPATIONAL THERAPIST/ OWNER",
        "authorized_official_telephone_number": "904-304-3902",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "OTR/L"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapist",
            "state": "FL",
            "license": "OT13759",
            "primary": true
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Speech-Language Pathologist",
            "state": "FL",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001583700",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2019; 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.