Individual provider Active NPI

Carl W Ocken, LMT

  • Contractor
  • Madeira Beach, FL
National Provider Identifier
1639348774
Registry record updated Feb 22, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
ContractorTaxonomy code 171W00000X
License
MA15315 Issued in FL
Practice address
13495 Gulf Blvd
Madeira Beach, FL 33708-2515
Phone
(727) 418-2387
Fax
(727) 398-2067
NPI assigned
Feb 22, 2008
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 22, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Contractor 171W00000X MA15315 FL Primary

Addresses

Primary practice location

13495 Gulf Blvd
Madeira Beach, FL 33708-2515

Mailing address

13495 Gulf Blvd
Madeira Beach, FL 33708-2515
Phone (727) 418-2387

Other identifiers 1

IdentifierTypeStateIssuer
MA15315OtherFLSTATE LICENSE

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
MA15315FLMDContractor

Practice roles

OrganizationSpecialtyStatusNew patients
Robert P. Fedor, D.O.P.a PastSince May 25, 2016 Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1203638400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1203638400000",
    "number": "1639348774",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13495 GULF BLVD",
            "city": "MADEIRA BEACH",
            "state": "FL",
            "postal_code": "337082515",
            "telephone_number": "727-418-2387",
            "fax_number": "727-398-2067"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13495 GULF BLVD",
            "city": "MADEIRA BEACH",
            "state": "FL",
            "postal_code": "337082515",
            "telephone_number": "727-418-2387",
            "fax_number": "727-398-2067"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OCKEN",
        "first_name": "CARL",
        "middle_name": "W",
        "credential": "LMT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-02-22",
        "last_updated": "2008-02-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171W00000X",
            "taxonomy_group": "",
            "desc": "Contractor",
            "state": "FL",
            "license": "MA15315",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "MA15315",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Madeira Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 2008; 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.