Individual provider Active NPI

Andrea Speed

  • Occupational Therapy Assistant
  • Lakeland, FL
National Provider Identifier
1720538135
Registry record updated Oct 10, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Therapy AssistantTaxonomy code 224Z00000X
License
OTA14862 Issued in FL
Practice address
4115 Audubon Oaks Cir
Apt 201
Lakeland, FL 33809-5943
Phone
(386) 416-9286
NPI assigned
Oct 10, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 10, 2016

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 OTA14862 FL Primary

Addresses

Primary practice location

4115 Audubon Oaks Cir
Apt 201
Lakeland, FL 33809-5943

Mailing address

4115 Audubon Oaks Cir
Apt 201
Lakeland, FL 33809-5943
Phone (386) 416-9286

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
OTA14862FLMDOccupational Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1476057600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1476057600000",
    "number": "1720538135",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4115 AUDUBON OAKS CIR",
            "address_2": "APT 201",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338095943",
            "telephone_number": "386-416-9286"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4115 AUDUBON OAKS CIR",
            "address_2": "APT 201",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338095943",
            "telephone_number": "386-416-9286"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPEED",
        "first_name": "ANDREA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-10-10",
        "last_updated": "2016-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "FL",
            "license": "OTA14862",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakeland, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2016; 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.