Active NPI
Anastasia Pona
- Occupational Therapist
- Fort Walton Beach, FL
National Provider Identifier
1700500923
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 22697
- Practice address
- 243 Hollywood Blvd NW
Fort Walton Beach, FL 32548-4725 - Phone
- (850) 852-0840
- NPI assigned
- Sep 30, 2022
- Last updated
- Sep 30, 2022
- 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 Therapist | 225X00000X | 22697 | FL | Primary |
Addresses
Primary practice location
243 Hollywood Blvd NW
Fort Walton Beach, FL 32548-4725
Mailing address
4245 Shadow LN
Niceville, FL 32578-4510
Phone (609) 661-1442
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 |
|---|---|---|---|
| 22697 | FL | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1664496000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1664496000000",
"number": "1700500923",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4245 SHADOW LN",
"city": "NICEVILLE",
"state": "FL",
"postal_code": "325784510",
"telephone_number": "609-661-1442"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "243 HOLLYWOOD BLVD NW",
"city": "FORT WALTON BEACH",
"state": "FL",
"postal_code": "325484725",
"telephone_number": "850-852-0840"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PONA",
"first_name": "ANASTASIA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-09-30",
"last_updated": "2022-09-30",
"certification_date": "2022-09-30",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "FL",
"license": "22697",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fort Walton Beach, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.