Individual provider Active NPI

Sarah Jean Schrader

  • Occupational Therapy Assistant
  • Port Saint Lucie, FL
National Provider Identifier
1770054926
Registry record updated Dec 16, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Therapy AssistantTaxonomy code 224Z00000X
License
OTA16904
Practice address
621 SW Kenyoun St
Port Saint Lucie, FL 34983-1873
Phone
(772) 342-8077
NPI assigned
Dec 16, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 16, 2018

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 OTA16904 Primary

Addresses

Primary practice location

621 SW Kenyoun St
Port Saint Lucie, FL 34983-1873

Mailing address

621 SW Kenyoun St
Port Saint Lucie, FL 34983-1873
Phone (772) 342-8077

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

NPI Registry JSON

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

{
    "created_epoch": "1544918400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1544918400000",
    "number": "1770054926",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "621 SW KENYOUN ST",
            "city": "PORT SAINT LUCIE",
            "state": "FL",
            "postal_code": "349831873",
            "telephone_number": "772-342-8077"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "621 SW KENYOUN ST",
            "city": "PORT SAINT LUCIE",
            "state": "FL",
            "postal_code": "349831873",
            "telephone_number": "772-342-8077"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHRADER",
        "first_name": "SARAH",
        "middle_name": "JEAN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-12-16",
        "last_updated": "2018-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": null,
            "license": "OTA16904",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Saint Lucie, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2018; 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.