Individual provider Active NPI

Karen Spisak, OTR

  • Pediatric Occupational Therapist
  • Bradenton, FL
National Provider Identifier
1730384785
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Occupational TherapistTaxonomy code 225XP0200X
License
OT4661 Issued in FL
Practice address
4440B 26TH St W
Bradenton, FL 34207-1201
Phone
(941) 752-0408
Fax
(941) 870-0876
NPI assigned
Jun 19, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Occupational Therapist 225XP0200X OT4661 FL Primary

Addresses

Primary practice location

4440B 26TH St W
Bradenton, FL 34207-1201

Mailing address

3007 48TH Avenue Dr E
Bradenton, FL 34203-3929
Phone (941) 752-0408

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
OT4661FLMDPediatric Occupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1182211200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1730384785",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3007 48TH AVENUE DR E",
            "city": "BRADENTON",
            "state": "FL",
            "postal_code": "342033929",
            "telephone_number": "941-752-0408",
            "fax_number": "941-870-0876"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4440B 26TH ST W",
            "city": "BRADENTON",
            "state": "FL",
            "postal_code": "342071201",
            "telephone_number": "941-752-0408",
            "fax_number": "941-870-0876"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPISAK",
        "first_name": "KAREN",
        "credential": "OTR",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-06-19",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "FL",
            "license": "OT4661",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bradenton, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.