Active NPI
Dawn Marie Friend, OTR/L
- Pediatric Occupational Therapist
- Fort Walton Beach, FL
National Provider Identifier
1679674832
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Occupational Therapist
- License
- OT11565
- Practice address
- 339 Racetrack Rd NW Ste 9
Fort Walton Beach, FL 32547-1580 - Phone
- (850) 862-7227
- NPI assigned
- Sep 26, 2006
- Last updated
- Jul 8, 2007
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Pediatric Occupational Therapist | 225XP0200X | OT11565 | FL | Primary |
Addresses
Primary practice location
339 Racetrack Rd NW Ste 9
Fort Walton Beach, FL 32547-1580
Mailing address
204 Southgate Dr
Crestview, FL 32539-6377
Phone (850) 423-0010
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 |
|---|---|---|---|
| OT11565 | FL | MD | Pediatric Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159228800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1679674832",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "204 SOUTHGATE DR",
"city": "CRESTVIEW",
"state": "FL",
"postal_code": "325396377",
"telephone_number": "850-423-0010"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "339 RACETRACK RD NW STE 9",
"city": "FORT WALTON BEACH",
"state": "FL",
"postal_code": "325471580",
"telephone_number": "850-862-7227"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FRIEND",
"first_name": "DAWN",
"middle_name": "MARIE",
"credential": "OTR/L",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-09-26",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "225XP0200X",
"taxonomy_group": "",
"desc": "Occupational Therapist, Pediatrics",
"state": "FL",
"license": "OT11565",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Fort Walton Beach, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.