Individual provider Active NPI

Whitney Michelle Irwin, COTA/L

  • Occupational Therapy Assistant
  • Green Cove Springs, FL
National Provider Identifier
1760849822
Registry record updated Jan 20, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Therapy AssistantTaxonomy code 224Z00000X
License
OTA 14300 Issued in FL
Practice address
803 Oak St
Green Cove Springs, FL 32043-4317
Phone
(904) 284-5568
NPI assigned
Jan 20, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 20, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy Assistant 224Z00000X OTA 14300 FL Primary

Addresses

Primary practice location

803 Oak St
Green Cove Springs, FL 32043-4317

Mailing address

9149 Hawkeye Dr
Jacksonville, FL 32221-3601
Phone (904) 885-3917

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
OTA 14300FLMDOccupational Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1453248000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1453248000000",
    "number": "1760849822",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9149 HAWKEYE DR",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322213601",
            "telephone_number": "904-885-3917"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "803 OAK ST",
            "city": "GREEN COVE SPRINGS",
            "state": "FL",
            "postal_code": "320434317",
            "telephone_number": "904-284-5568"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IRWIN",
        "first_name": "WHITNEY",
        "middle_name": "MICHELLE",
        "credential": "COTA/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-01-20",
        "last_updated": "2016-01-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "FL",
            "license": "OTA 14300",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Green Cove Springs, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 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.

Verify at the official NPI Registry.