Individual provider Active NPI

Nicole Marie Falk, OTR

  • Occupational Therapist
  • Clearwater, FL
National Provider Identifier
1689854911
Registry record updated Oct 19, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
OT 12938 Issued in FL
Practice address
1700 N McMullen Booth Rd
Clearwater, FL 33759-2130
Phone
(727) 967-3025
NPI assigned
Nov 3, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 19, 2021

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 OT 12938 FL Primary

Addresses

Primary practice location

1700 N McMullen Booth Rd
Clearwater, FL 33759-2130

Mailing address

621 Whisper Cove CT
Dunedin, FL 34698-8049
Phone (786) 259-7422

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240805002156 FL Practitioner - Occupational Therapist in Private Practice 1052858362 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OT 12938FLMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Fox Rehab OT FL LLC Occupational Therapist CurrentSince Jul 1, 2024 Accepting new patients
B & V Thera Pro Associates Corp Occupational Therapist Past Accepting new patients

Locations

3882 Central Sarasota Pkwy
Sarasota, FL 34238
Phone (941) 282-7965

7 Carnegie Plz
Cherry Hill, NJ 08003

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": "1194048000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1634601600000",
    "number": "1689854911",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "621 WHISPER COVE CT",
            "city": "DUNEDIN",
            "state": "FL",
            "postal_code": "346988049",
            "telephone_number": "786-259-7422"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1700 N MCMULLEN BOOTH RD",
            "city": "CLEARWATER",
            "state": "FL",
            "postal_code": "337592130",
            "telephone_number": "727-967-3025"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FALK",
        "first_name": "NICOLE",
        "middle_name": "MARIE",
        "name_prefix": "Ms.",
        "credential": "OTR",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-11-03",
        "last_updated": "2021-10-19",
        "certification_date": "2021-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "FL",
            "license": "OT 12938",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clearwater, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2021; 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.