Individual provider Active NPI

Raena Fegurgur

  • Occupational Therapist
  • Niceville, FL
National Provider Identifier
1730006560
Registry record updated Jul 2, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
OT25494 Issued in FL
Practice address
4565 Commercial Dr Ste 105
Niceville, FL 32578-8856
Phone
(850) 353-2415
NPI assigned
Jul 2, 2026
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 2, 2026

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 OT25494 FL Primary

Addresses

Primary practice location

4565 Commercial Dr Ste 105
Niceville, FL 32578-8856

Mailing address

4565 Commercial Dr Ste 105
Niceville, FL 32578-8856
Phone (850) 353-2415

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

Practice roles

OrganizationSpecialtyStatusNew patients
Kidz Korner PastSince May 8, 2022 Accepting new patients
Shine-Pediatric Therapy Center Occupational Therapist PastSince Oct 12, 2025 Accepting new patients

Organizations & group practices 2

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": "1782950400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1782950400000",
    "number": "1730006560",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4565 COMMERCIAL DR STE 105",
            "city": "NICEVILLE",
            "state": "FL",
            "postal_code": "325788856",
            "telephone_number": "850-353-2415"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4565 COMMERCIAL DR STE 105",
            "city": "NICEVILLE",
            "state": "FL",
            "postal_code": "325788856",
            "telephone_number": "850-353-2415"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FEGURGUR",
        "first_name": "RAENA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-07-02",
        "last_updated": "2026-07-02",
        "certification_date": "2026-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "FL",
            "license": "OT25494",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Niceville, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2026; 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.