Individual provider Active NPI

Carolyn Squire, OTR/L

  • Occupational Therapist
  • Sarasota, FL
National Provider Identifier
1750784062
Registry record updated Sep 12, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
1963 Issued in FL
Practice address
4630 17TH St
Sarasota, FL 34235-1843
Phone
(941) 487-5000
NPI assigned
Sep 30, 2014
Last updated
Sep 12, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 12, 2025

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 1963 FL
Occupational Therapist 225X00000X 1963 FL Primary
Pediatric Occupational Therapist 225XP0200X NU
Physical Rehabilitation Occupational Therapist 225XP0019X NU

Addresses

Primary practice location

4630 17TH St
Sarasota, FL 34235-1843

Mailing address

4630 17TH St
Sarasota, FL 34235-1843
Phone (941) 957-8935

Other practice location 1

12220 Towne Lake Dr Ste 1
Fort Myers, FL 33913-8021
Phone (941) 487-5400

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20201229001526 FL Practitioner - Occupational Therapist in Private Practice 1951714526

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1963FLMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Carolyn Squire, LLC Occupational Therapist CurrentSince May 16, 2021 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1412035200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757635200000",
    "number": "1750784062",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4630 17TH ST",
            "city": "SARASOTA",
            "state": "FL",
            "postal_code": "342351843",
            "telephone_number": "941-957-8935",
            "fax_number": "941-487-5430"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4630 17TH ST",
            "city": "SARASOTA",
            "state": "FL",
            "postal_code": "342351843",
            "telephone_number": "941-487-5000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "12220 Towne Lake Dr Ste 1",
            "address_purpose": "LOCATION",
            "city": "Fort Myers",
            "state": "FL",
            "postal_code": "339138021",
            "country_code": "US",
            "telephone_number": "941-487-5400",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SQUIRE",
        "first_name": "CAROLYN",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-09-30",
        "last_updated": "2025-09-12",
        "certification_date": "2025-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "FL",
            "license": "1963",
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "FL",
            "license": "1963",
            "primary": true
        },
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "225XP0019X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Physical Rehabilitation",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sarasota, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.