Active NPI
Jaime Antonio Correa, OTR-L
- Pediatric Occupational Therapist
- Weston, FL
National Provider Identifier
1699929752
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Occupational Therapist
- License
- OT13392
- Practice address
- 2685 Executive Park Dr
Suite 4
Weston, FL 33331-3651 - Phone
- (954) 515-0892
- Fax
- (954) 349-0896
- NPI assigned
- Nov 15, 2008
- Last updated
- Oct 13, 2011
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Pediatric Occupational Therapist | 225XP0200X | OT13392 | FL | Primary |
Addresses
Primary practice location
2685 Executive Park Dr
Suite 4
Weston, FL 33331-3651
Mailing address
710 Amherst Ave
Davie, FL 33325-3004
Phone (305) 302-4242
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 |
|---|---|---|---|
| OT13392 | FL | MD | Pediatric Occupational Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Quality Rehab Care LLC | Past | Accepting new patients | |
| A Therapy Inc | Past | Accepting new patients |
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Physical Therapist
- Weston, FL
- NPI 1205949328
-
- Physical Therapy Clinic/Center
- Weston, FL
- NPI 1114194297
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1226707200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1318464000000",
"number": "1699929752",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "710 AMHERST AVE",
"city": "DAVIE",
"state": "FL",
"postal_code": "333253004",
"telephone_number": "305-302-4242",
"fax_number": "305-349-0896"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2685 EXECUTIVE PARK DR",
"address_2": "SUITE 4",
"city": "WESTON",
"state": "FL",
"postal_code": "333313651",
"telephone_number": "954-515-0892",
"fax_number": "954-349-0896"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CORREA",
"first_name": "JAIME",
"middle_name": "ANTONIO",
"credential": "OTR-L",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2008-11-15",
"last_updated": "2011-10-13",
"status": "A"
},
"taxonomies": [
{
"code": "225XP0200X",
"taxonomy_group": "",
"desc": "Occupational Therapist, Pediatrics",
"state": "FL",
"license": "OT13392",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Weston, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.