Active NPI
Wendy Ann Ingram, COTA
- Occupational Therapy Assistant
- Titusville, FL
National Provider Identifier
1700442373
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapy Assistant
- License
- 13989
- Practice address
- 1705 Jess Parrish CT
Titusville, FL 32796-2158 - Phone
- (321) 269-5720
- NPI assigned
- May 19, 2019
- Sex
- Female
- Sole proprietor
- No
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 Therapy Assistant | 224Z00000X | 13989 | FL | Primary |
Addresses
Primary practice location
1705 Jess Parrish CT
Titusville, FL 32796-2158
Mailing address
3128 Sir Hamilton Cir
Titusville, FL 32780-4962
Phone (407) 233-5244
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 |
|---|---|---|---|
| 13989 | FL | MD | Occupational Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1558224000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1558224000000",
"number": "1700442373",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3128 SIR HAMILTON CIR",
"city": "TITUSVILLE",
"state": "FL",
"postal_code": "327804962",
"telephone_number": "407-233-5244"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1705 JESS PARRISH CT",
"city": "TITUSVILLE",
"state": "FL",
"postal_code": "327962158",
"telephone_number": "321-269-5720"
}
],
"practiceLocations": [],
"basic": {
"last_name": "INGRAM",
"first_name": "WENDY",
"middle_name": "ANN",
"name_prefix": "Ms.",
"credential": "COTA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-05-19",
"last_updated": "2019-05-19",
"status": "A"
},
"taxonomies": [
{
"code": "224Z00000X",
"taxonomy_group": "",
"desc": "Occupational Therapy Assistant",
"state": "FL",
"license": "13989",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Titusville, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.