Individual provider Active NPI

Jonette Ishmael

  • Occupational Therapist
  • Ocala, FL
National Provider Identifier
1669215646
Registry record updated Jun 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
20144 Issued in FL
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

Updated by the provider on Jun 17, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
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

Enrollment IDStateProvider typePAC IDDetails
I20250407002535 VA Practitioner - Occupational Therapist in Private Practice 9638693005 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
20144FLMDPhysical Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Legacy Healthcare Services Inc Occupational Therapist CurrentSince Mar 24, 2025 Accepting new patients
Legacy Healthcare Services Inc Occupational Therapist CurrentSince Mar 24, 2025 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.

Verify at the official NPI Registry.