Individual provider Active NPI

Melissa Gale T Potes, OTR/L

  • Occupational Therapist
  • Kissimmee, FL
National Provider Identifier
1720169485
Registry record updated Sep 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
OT12396 Issued in FL
Practice address
324 W Oak St
Kissimmee, FL 34741-4443
Phone
(407) 343-9826
NPI assigned
Oct 18, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 6, 2023

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 OT12396 FL Primary

Addresses

Primary practice location

324 W Oak St
Kissimmee, FL 34741-4443

Mailing address

2461 Huron Cir
Kissimmee, FL 34746-3443
Phone (407) 452-0264

Other identifiers 1

IdentifierTypeStateIssuer
PENDINGMedicaidFL

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
OT12396FLMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Central Florida Pediatric & Adult Therapy Services, Inc. Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1161129600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693958400000",
    "number": "1720169485",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2461 HURON CIR",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "347463443",
            "telephone_number": "407-452-0264"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "324 W OAK ST",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "347414443",
            "telephone_number": "407-343-9826"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POTES",
        "first_name": "MELISSA GALE",
        "middle_name": "T",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-18",
        "last_updated": "2023-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "FL",
            "license": "OT12396",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PENDING",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kissimmee, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 2023; 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.