Individual provider Active NPI

Jaime Antonio Correa, OTR-L

  • Pediatric Occupational Therapist
  • Weston, FL
National Provider Identifier
1699929752
Registry record updated Oct 13, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Occupational TherapistTaxonomy code 225XP0200X
License
OT13392 Issued in FL
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, 2011By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 13, 2011

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
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

LicenseStateTypeSpecialty
OT13392FLMDPediatric Occupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Quality Rehab Care LLC Past Accepting new patients
A Therapy Inc PastSince Apr 28, 2020 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.

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.

Verify at the official NPI Registry.