Individual provider Active NPI

Sara Osterhout

  • Occupational Therapy Assistant
  • Daytona Beach, FL
National Provider Identifier
1720412067
Registry record updated Aug 22, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Therapy AssistantTaxonomy code 224Z00000X
License
OTA 13074 Issued in FL
Practice address
1219 Dunn Ave
Daytona Beach, FL 32114-2405
Phone
(386) 255-4568
NPI assigned
Aug 22, 2013
Last updated
Aug 22, 2013By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy Assistant 224Z00000X OTA 13074 FL Primary

Addresses

Primary practice location

1219 Dunn Ave
Daytona Beach, FL 32114-2405

Mailing address

4 Palmetto Dunes CT
Ormond Beach, FL 32174-8782

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
OTA 13074FLMDOccupational Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1377129600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1377129600000",
    "number": "1720412067",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4 PALMETTO DUNES CT",
            "city": "ORMOND BEACH",
            "state": "FL",
            "postal_code": "321748782"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1219 DUNN AVE",
            "city": "DAYTONA BEACH",
            "state": "FL",
            "postal_code": "321142405",
            "telephone_number": "386-255-4568"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OSTERHOUT",
        "first_name": "SARA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-08-22",
        "last_updated": "2013-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "FL",
            "license": "OTA 13074",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Daytona Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 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.