NPIMap

Organization Active NPI

Triple E OT Inc

  • Pediatric Occupational Therapist
  • Crestview, FL
National Provider Identifier
1710271374
Registry record updated Jun 1, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Occupational TherapistTaxonomy code 225XP0200X
License
OT5156 Issued in FL
Legal business name
TRIPLE E OT INC
Practice address
4100 S Ferdon Blvd
Suite C1
Crestview, FL 32536-5252
Phone
(850) 682-8388
Fax
(850) 682-7463
NPI assigned
Jun 1, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 1, 2011

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

Authorized official

Name
Mrs. Kim Evelyn Hydle, OTR/L
Title
Occupational Therapist
Phone
(850) 401-1227

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Occupational TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225XP0200X OT5156 FL Primary

Addresses

Primary practice location

4100 S Ferdon Blvd
Suite C1
Crestview, FL 32536-5252

Mailing address

450 Lakeview Dr
Defuniak Springs, FL 32433-4058
Phone (850) 401-1227

National Provider Directory

National Provider Directory
Tax ID family
Triple E OT Inc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1306886400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1306886400000",
    "number": "1710271374",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "450 LAKEVIEW DR",
            "city": "DEFUNIAK SPRINGS",
            "state": "FL",
            "postal_code": "324334058",
            "telephone_number": "850-401-1227",
            "fax_number": "850-682-7463"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4100 S FERDON BLVD",
            "address_2": "SUITE C1",
            "city": "CRESTVIEW",
            "state": "FL",
            "postal_code": "325365252",
            "telephone_number": "850-682-8388",
            "fax_number": "850-682-7463"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRIPLE E OT INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-06-01",
        "last_updated": "2011-06-01",
        "status": "A",
        "authorized_official_last_name": "HYDLE",
        "authorized_official_first_name": "KIM",
        "authorized_official_middle_name": "EVELYN",
        "authorized_official_title_or_position": "OCCUPATIONAL THERAPIST",
        "authorized_official_telephone_number": "850-401-1227",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "OTR/L"
    },
    "taxonomies": [
        {
            "code": "225XP0200X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "FL",
            "license": "OT5156",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Crestview, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 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.