Individual provider Active NPI

Tara Eriksen, OTR

  • Occupational Therapist
  • Bradenton, FL
National Provider Identifier
1710101498
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
OT12006 Issued in FL
Practice address
4440B 26TH St W
Bradenton, FL 34207-1201
Phone
(941) 752-0408
Fax
(941) 870-0876
NPI assigned
Apr 12, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X OT12006 FL Primary

Addresses

Primary practice location

4440B 26TH St W
Bradenton, FL 34207-1201

Mailing address

4440B 26TH St W
Bradenton, FL 34207-1201
Phone (941) 752-0408

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
OT12006FLMDOccupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1176336000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1710101498",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4440B 26TH ST W",
            "city": "BRADENTON",
            "state": "FL",
            "postal_code": "342071201",
            "telephone_number": "941-752-0408",
            "fax_number": "941-870-0876"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4440B 26TH ST W",
            "city": "BRADENTON",
            "state": "FL",
            "postal_code": "342071201",
            "telephone_number": "941-752-0408",
            "fax_number": "941-870-0876"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ERIKSEN",
        "first_name": "TARA",
        "credential": "OTR",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-12",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "FL",
            "license": "OT12006",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bradenton, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.