Active NPI
Samantha McDonald
- Occupational Therapy Assistant
- Orlando, FL
National Provider Identifier
1730633371
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapy Assistant
- License
- OTA14790
- Practice address
- 1250 Christy Ave
Orlando, FL 32803-2128 - Phone
- (727) 215-0277
- NPI assigned
- Aug 11, 2016
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapy Assistant | 224Z00000X | OTA14790 | FL | Primary |
Addresses
Primary practice location
1250 Christy Ave
Orlando, FL 32803-2128
Mailing address
1250 Christy Ave
Orlando, FL 32803-2128
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| EAHCA013Z | Medicaid | FL |
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
| License | State | Type | Specialty |
|---|---|---|---|
| OTA14790 | FL | MD | Occupational Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1470873600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1470873600000",
"number": "1730633371",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1250 CHRISTY AVE",
"city": "ORLANDO",
"state": "FL",
"postal_code": "328032128"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1250 CHRISTY AVE",
"city": "ORLANDO",
"state": "FL",
"postal_code": "328032128",
"telephone_number": "727-215-0277"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCDONALD",
"first_name": "SAMANTHA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2016-08-11",
"last_updated": "2016-08-11",
"status": "A"
},
"taxonomies": [
{
"code": "224Z00000X",
"taxonomy_group": "",
"desc": "Occupational Therapy Assistant",
"state": "FL",
"license": "OTA14790",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "EAHCA013Z",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Orlando, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 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.