Individual provider Active NPI

Amy Lynn Grahn, OTR/L

  • Gerontology Occupational Therapist
  • Cape Coral, FL
National Provider Identifier
1710313721
Registry record updated Sep 23, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Occupational TherapistTaxonomy code 225XG0600X
License
OT15909 Issued in FL
Practice address
216 Santa Barbara Blvd
Cape Coral, FL 33991-2031
Phone
(239) 573-9693
NPI assigned
Sep 23, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 23, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Occupational Therapist 225XG0600X OT15909 FL Primary

Addresses

Primary practice location

216 Santa Barbara Blvd
Cape Coral, FL 33991-2031

Mailing address

216 Santa Barbara Blvd
Cape Coral, FL 33991-2031
Phone (239) 573-9693

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
OT15909FLMDGerontology Occupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1379894400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1379894400000",
    "number": "1710313721",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "216 SANTA BARBARA BLVD",
            "city": "CAPE CORAL",
            "state": "FL",
            "postal_code": "339912031",
            "telephone_number": "239-573-9693"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "216 SANTA BARBARA BLVD",
            "city": "CAPE CORAL",
            "state": "FL",
            "postal_code": "339912031",
            "telephone_number": "239-573-9693"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAHN",
        "first_name": "AMY",
        "middle_name": "LYNN",
        "name_prefix": "Ms.",
        "credential": "OTR/L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-09-23",
        "last_updated": "2013-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XG0600X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Gerontology",
            "state": "FL",
            "license": "OT15909",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cape Coral, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2013; 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.