Active NPI
Jonette Ishmael
- Occupational Therapist
- Ocala, FL
National Provider Identifier
1669215646
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 20144
- Practice address
- 3628 SE 45TH Avenue Rd
Ocala, FL 34480-1623 - Phone
- (347) 551-2793
- NPI assigned
- Jun 17, 2024
- 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 Therapist | 225X00000X | 20144 | FL | Primary |
Addresses
Primary practice location
3628 SE 45TH Avenue Rd
Ocala, FL 34480-1623
Mailing address
3628 SE 45TH Avenue Rd
Ocala, FL 34480-1623
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in VA
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 20144 | FL | MD | Physical Therapy Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Legacy Healthcare Services Inc | Occupational Therapist | Current | Accepting new patients |
| Legacy Healthcare Services Inc | Occupational Therapist | Current | Accepting new patients |
Locations
110 Horizon Dr
#310
Raleigh, NC 27615
3365 Ogden Rd
Roanoke, VA 24018
Phone (540) 682-7500
Organizations & group practices 2
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": "1718582400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1718582400000",
"number": "1669215646",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3628 SE 45TH AVENUE RD",
"city": "OCALA",
"state": "FL",
"postal_code": "344801623"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3628 SE 45TH AVENUE RD",
"city": "OCALA",
"state": "FL",
"postal_code": "344801623",
"telephone_number": "347-551-2793"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ISHMAEL",
"first_name": "JONETTE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2024-06-17",
"last_updated": "2024-06-17",
"certification_date": "2024-06-17",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "FL",
"license": "20144",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Ocala, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.