Active NPI
Alysia S Reppeto-Evans, COTA/L
- Occupational Therapy Assistant
- Lakeland, FL
National Provider Identifier
1659610210
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapy Assistant
- License
- OTA 10171
- Practice address
- 2330 Creek Side Dr
Lakeland, FL 33811-1438 - Phone
- (863) 701-5546
- NPI assigned
- Feb 1, 2013
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapy Assistant | 224Z00000X | OTA 10171 | FL | Primary |
Addresses
Primary practice location
2330 Creek Side Dr
Lakeland, FL 33811-1438
Mailing address
2330 Creek Side Dr
Lakeland, FL 33811-1438
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
| License | State | Type | Specialty |
|---|---|---|---|
| OTA 10171 | FL | MD | Occupational Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1359676800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1359676800000",
"number": "1659610210",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2330 CREEK SIDE DR",
"city": "LAKELAND",
"state": "FL",
"postal_code": "338111438"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2330 CREEK SIDE DR",
"city": "LAKELAND",
"state": "FL",
"postal_code": "338111438",
"telephone_number": "863-701-5546"
}
],
"practiceLocations": [],
"basic": {
"last_name": "REPPETO-EVANS",
"first_name": "ALYSIA",
"middle_name": "S",
"name_prefix": "Ms.",
"credential": "COTA/L",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2013-02-01",
"last_updated": "2013-02-01",
"status": "A"
},
"taxonomies": [
{
"code": "224Z00000X",
"taxonomy_group": "",
"desc": "Occupational Therapy Assistant",
"state": "FL",
"license": "OTA 10171",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lakeland, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.