Individual provider Active NPI

Terri Williams, OTR/L

  • Occupational Therapist
  • Jacksonville, FL
National Provider Identifier
1790758597
Registry record updated Dec 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
OT10282 Issued in FL
Practice address
484 Riverside Ave
Jacksonville, FL 32202-4912
Phone
(904) 579-2824
NPI assigned
Feb 10, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 16, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X OT10282 FL Primary

Addresses

Primary practice location

484 Riverside Ave
Jacksonville, FL 32202-4912

Mailing address

PO Box 932184
Atlanta, GA 31193-5912
Phone (856) 678-3484

Other identifiers 1

IdentifierTypeStateIssuer
688354196MedicaidFL

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241231002802 FL Practitioner - Occupational Therapist in Private Practice 6002343175 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Action Therapy Group LLCGroup PAC ID 6305258013, 69 clinicians

Practice addresses (Care Compare)

2110 Fleischmann Rd
Tallahassee, FL 32308-0562
Phone (850) 741-6715

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OT10282FLMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
H2 Rehabilitation Services of Florida LLC CurrentSince Dec 1, 2024 Accepting new patients
H2 Rehabilitation Services of Florida LLC CurrentSince Dec 1, 2024 Accepting new patients
Action Therapy Group LLC CurrentSince Aug 1, 2025 Accepting new patients

Locations

831 Santa Barbara Blvd
Ste 227
Cape Coral, FL 33991

484 Riverside Ave
Jacksonville, FL 32202
Phone (904) 579-2824

3964 Florida Ave
Jay, FL 32565
Phone (850) 675-4000

Organizations & group practices 3

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

NPI Registry JSON

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

{
    "created_epoch": "1139529600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734307200000",
    "number": "1790758597",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 932184",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "311935912",
            "telephone_number": "856-678-3484"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "484 RIVERSIDE AVE",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322024912",
            "telephone_number": "904-579-2824"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "TERRI",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-10",
        "last_updated": "2024-12-16",
        "certification_date": "2024-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "FL",
            "license": "OT10282",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "688354196",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.