Active NPI
Theresa Lynn Paddock, OTR/L
- Occupational Therapist
- Largo, FL
National Provider Identifier
1679037162
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 19107
- Practice address
- 8254 118TH Ave N
Suite 100
Largo, FL 33773 - Phone
- (727) 541-5304
- NPI assigned
- Jan 29, 2019
- Last updated
- Jan 29, 2019
- 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 | 19107 | FL | Primary |
Addresses
Primary practice location
8254 118TH Ave N
Suite 100
Largo, FL 33773
Mailing address
5220 13TH Avenue Dr W
Bradenton, FL 34209-4235
Phone (248) 420-7186
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1020264 | Other | NATIONAL BOARD CERTIFICATION | |
| 2015 | Other | OK | LICENSURE |
| 5201004033 | Other | MI | LICENSURE |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 19107 | FL | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1548720000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1548720000000",
"number": "1679037162",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5220 13TH AVENUE DR W",
"city": "BRADENTON",
"state": "FL",
"postal_code": "342094235",
"telephone_number": "248-420-7186"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8254 118TH AVE N",
"address_2": "SUITE 100",
"city": "LARGO",
"state": "FL",
"postal_code": "33773",
"telephone_number": "727-541-5304"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PADDOCK",
"first_name": "THERESA",
"middle_name": "LYNN",
"credential": "OTR/L",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2019-01-29",
"last_updated": "2019-01-29",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "FL",
"license": "19107",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NATIONAL BOARD CERTIFICATION",
"identifier": "1020264",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LICENSURE",
"identifier": "2015",
"state": "OK"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LICENSURE",
"identifier": "5201004033",
"state": "MI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Largo, FL
- Our Corner, LLC
- Our Family Doctors P L L C
- Our Hearts Home Care & Staffing LLC (Our Hearts Home Care)
- Carron J. Oxley, CRNA
- Elizabeth Rose Pacer, MD
- Helen Padilla, RN
- Rosali Padron Jerez, RBT
- Teresa Palenzuela, PTA
- Palm Garden of Largo LLC (Palm Garden of Largo)
- Palm Garden of Pinellas LLC (Palm Garden of Pinellas)
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.