Active NPI
Rachel Fuller, COTA/L
- Occupational Therapy Assistant
- Gulf Breeze, FL
National Provider Identifier
1780362665
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapy Assistant
- License
- 19105
- Practice address
- 50 Joachim Dr
Gulf Breeze, FL 32561-4474 - Phone
- (850) 898-9506
- NPI assigned
- Jul 10, 2023
- Last updated
- Jul 10, 2023
- Sex
- Female
- Sole proprietor
- No
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 | 19105 | FL | Primary |
Addresses
Primary practice location
50 Joachim Dr
Gulf Breeze, FL 32561-4474
Mailing address
10816 Creek Ridge Dr
Pensacola, FL 32506-8218
Phone (270) 498-0841
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 |
|---|---|---|---|
| 19105 | FL | MD | Occupational Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1688947200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1688947200000",
"number": "1780362665",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10816 CREEK RIDGE DR",
"city": "PENSACOLA",
"state": "FL",
"postal_code": "325068218",
"telephone_number": "270-498-0841"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "50 JOACHIM DR",
"city": "GULF BREEZE",
"state": "FL",
"postal_code": "325614474",
"telephone_number": "850-898-9506"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FULLER",
"first_name": "RACHEL",
"credential": "COTA/L",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-07-10",
"last_updated": "2023-07-10",
"certification_date": "2023-07-10",
"status": "A"
},
"taxonomies": [
{
"code": "224Z00000X",
"taxonomy_group": "",
"desc": "Occupational Therapy Assistant",
"state": "FL",
"license": "19105",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Gulf Breeze, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.