NPIMap

Organization Active NPI

Apd - Tacachale

  • Occupational Therapist
  • Gainesville, FL
National Provider Identifier
1750523957
Registry record updated Apr 2, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
OT2972 Issued in FL
Legal business name
APD - TACACHALE
Practice address
1621 NE Waldo Rd
Gainesville, FL 32609-3900
Phone
(352) 955-5884
NPI assigned
Apr 2, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 2, 2009

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

Authorized official

Name
Mr. Don E Thomas
Title
Superintendent
Phone
(352) 955-5856

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225100000X PT18456 FL
Physical Therapy AssistantGroup: 193200000X MULTI-SPECIALTY GROUP 225200000X PTA16188 FL
Occupational TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225X00000X OT2972 FL Primary

Addresses

Primary practice location

1621 NE Waldo Rd
Gainesville, FL 32609-3900

Mailing address

1621 NE Waldo Rd
Gainesville, FL 32609-3900
Phone (352) 955-5668

Other identifiers 1

IdentifierTypeStateIssuer
681084596MedicaidFL

National Provider Directory

National Provider Directory
Tax ID family
Agency for Persons With Disabilities12 organizations share this tax ID, including this one

Other organizations with this tax ID 11

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1238630400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1238630400000",
    "number": "1750523957",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1621 NE WALDO RD",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326093900",
            "telephone_number": "352-955-5668"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1621 NE WALDO RD",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326093900",
            "telephone_number": "352-955-5884"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "APD - TACACHALE",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-04-02",
        "last_updated": "2009-04-02",
        "status": "A",
        "authorized_official_last_name": "THOMAS",
        "authorized_official_first_name": "DON",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "SUPERINTENDENT",
        "authorized_official_telephone_number": "352-955-5856",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PT18456",
            "primary": false
        },
        {
            "code": "225200000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapy Assistant",
            "state": "FL",
            "license": "PTA16188",
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapist",
            "state": "FL",
            "license": "OT2972",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "681084596",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Gainesville, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 2009; 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.