Active NPI
Louann Macclellan, OTR
- Occupational Therapist
- Crescent City, FL
National Provider Identifier
1699898486
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- OT1893
- Practice address
- 405 S. Summit St.
Unit F
Crescent City, FL 32112-3031 - Phone
- (386) 698-4720
- Fax
- (386) 698-4866
- NPI assigned
- Apr 9, 2007
- 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 | OT1893 | FL | Primary |
Addresses
Primary practice location
405 S. Summit St.
Unit F
Crescent City, FL 32112-3031
Mailing address
501 County Road 310
Palatka, FL 32177-9470
Phone (386) 328-4713
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 |
|---|---|---|---|
| OT1893 | FL | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1176076800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1224720000000",
"number": "1699898486",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "501 COUNTY ROAD 310",
"city": "PALATKA",
"state": "FL",
"postal_code": "321779470",
"telephone_number": "386-328-4713"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "405 S. SUMMIT ST.",
"address_2": "UNIT F",
"city": "CRESCENT CITY",
"state": "FL",
"postal_code": "321123031",
"telephone_number": "386-698-4720",
"fax_number": "386-698-4866"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MACCLELLAN",
"first_name": "LOUANN",
"credential": "OTR",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-04-09",
"last_updated": "2008-10-23",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "FL",
"license": "OT1893",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Crescent City, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.