Michelle L Martin, OT

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

OT9896 Issued in FL

Practice address

3311 Bayshore Blvd NE
Saint Petersburg, FL 33703-5507

Phone

(239) 560-9663

NPI assigned

Nov 30, 2011

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Michelle L Van Gorder Former name

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

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.

• Optimized Therapy Transitions, LLC

  • Occupational Therapist
  • St Petersburg, FL
  • NPI 1891346680
  Medicare reassignment Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1322611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1681689600000",
    "number": "1700153111",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3311 BAYSHORE BLVD NE FL 33703",
            "city": "SAINT PETERSBURG",
            "state": "FL",
            "postal_code": "337035507",
            "telephone_number": "239-560-9663"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3311 BAYSHORE BLVD NE",
            "city": "SAINT PETERSBURG",
            "state": "FL",
            "postal_code": "337035507",
            "telephone_number": "239-560-9663"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8892 Fawn Ridge Dr",
            "address_purpose": "LOCATION",
            "city": "Fort Myers",
            "state": "FL",
            "postal_code": "339121481",
            "country_code": "US",
            "telephone_number": "239-560-9663",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "MICHELLE",
        "middle_name": "L",
        "credential": "OT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-11-30",
        "last_updated": "2023-04-17",
        "certification_date": "2023-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "FL",
            "license": "OT9896",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MICHELLE",
            "last_name": "VAN GORDER",
            "middle_name": "L",
            "credential": "OT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Desiree Martin, RN
• Elijah Martin
• Ismael J Martin
• John F Martin, R.PH.
• Meghan Elizabeth Beach Martin, MD
• Nicole Martin, FNP-C
• Philip Joseph Martin, M.D.
• Phyllis Jean Martin, BA, CPRP
• Renee Martin, CF-SLP
• Nathalia Martinez Tobar, MD

• Occupational Therapist in Saint Petersburg, FL
• Providers in Saint Petersburg, FL by specialty
• Occupational Therapist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 2023; 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.