Individual provider Active NPI

Kristy L Schabacker, MSOTRL

  • Occupational Therapist
  • Longwood, FL
National Provider Identifier
1669679650
Registry record updated Jan 31, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
OT11550 Issued in FL
Practice address
455 W Warren Ave Ste 200
Longwood, FL 32750-4038
Phone
(407) 260-0551
NPI assigned
Jul 2, 2007
Last updated
Jan 31, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 31, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 11550 FL
Occupational Therapist 225X00000X OT11550 FL Primary

Addresses

Primary practice location

455 W Warren Ave Ste 200
Longwood, FL 32750-4038

Mailing address

455 W Warren Ave Ste 200
Longwood, FL 32750-4038
Phone (407) 260-0551

Other identifiers 2

IdentifierTypeStateIssuer
1669679650MedicaidFL
OT11550OtherFLOT 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)
Enrolled

State licenses

LicenseStateTypeSpecialty
11550FLMDOccupational Therapist
OT11550FLMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Sobe Innovative Rehabilitation PLLC Occupational Therapist CurrentSince Jul 28, 2023 Accepting new patients
Healthpro Heritage Rehab & Fitness, LLC Occupational Therapist CurrentSince Nov 21, 2021 Accepting new patients
Healthpro Heritage Rehab & Fitness, LLC Occupational Therapist CurrentSince Nov 21, 2021 Accepting new patients

Locations

2777 NE 183rd St
Aventura, FL 33160
Phone (305) 405-2014

160 Islander Ct
Longwood, FL 32750
Phone (407) 260-1108

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1183334400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643587200000",
    "number": "1669679650",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "455 W WARREN AVE STE 200",
            "city": "LONGWOOD",
            "state": "FL",
            "postal_code": "327504038",
            "telephone_number": "407-260-0551"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "455 W WARREN AVE STE 200",
            "city": "LONGWOOD",
            "state": "FL",
            "postal_code": "327504038",
            "telephone_number": "407-260-0551"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHABACKER",
        "first_name": "KRISTY",
        "middle_name": "L",
        "name_prefix": "Ms.",
        "credential": "MSOTRL",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-07-02",
        "last_updated": "2022-01-31",
        "certification_date": "2022-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "FL",
            "license": "11550",
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "FL",
            "license": "OT11550",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1669679650",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OT LICENSE",
            "identifier": "OT11550",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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 Jan 31, 2022; 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.