Individual provider Active NPI

Megan Claire Elder-Dwight, COTA/L

  • Occupational Therapy Assistant
  • Longwood, FL
National Provider Identifier
1639415201
Registry record updated Jun 16, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Therapy AssistantTaxonomy code 224Z00000X
License
COTA/L 9828 Issued in FL
Practice address
2639 W State Road 434
Longwood, FL 32779-4878
Phone
(407) 925-5623
NPI assigned
Dec 29, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 16, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy Assistant 224Z00000X COTA/L 9828 FL Primary

Addresses

Primary practice location

2639 W State Road 434
Longwood, FL 32779-4878

Mailing address

3018 Blue Shores Way
New Smyrna Beach, FL 32168-2447
Phone (407) 925-5623

Other practice location 1

1200 N Central Ave Ste Apt 304
Kissimmee, FL 34741-4450
Phone (407) 925-5623

Other names 1

  • Megan Claire Keith Former name

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
COTA/L 9828FLMDOccupational Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1356739200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623801600000",
    "number": "1639415201",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3018 BLUE SHORES WAY",
            "city": "NEW SMYRNA BEACH",
            "state": "FL",
            "postal_code": "321682447",
            "telephone_number": "407-925-5623"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2639 W STATE ROAD 434",
            "city": "LONGWOOD",
            "state": "FL",
            "postal_code": "327794878",
            "telephone_number": "407-925-5623"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1200 N Central Ave Ste Apt 304",
            "address_purpose": "LOCATION",
            "city": "Kissimmee",
            "state": "FL",
            "postal_code": "347414450",
            "country_code": "US",
            "telephone_number": "407-925-5623",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ELDER-DWIGHT",
        "first_name": "MEGAN",
        "middle_name": "CLAIRE",
        "name_prefix": "Ms.",
        "credential": "COTA/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-12-29",
        "last_updated": "2021-06-16",
        "certification_date": "2021-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "FL",
            "license": "COTA/L 9828",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MEGAN",
            "last_name": "KEITH",
            "middle_name": "CLAIRE",
            "credential": "COTA/L",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Longwood, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 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.

Verify at the official NPI Registry.