Active NPI
Niemat Issa
- Physical Rehabilitation Occupational Therapist
- Jacksonville, FL
National Provider Identifier
1801281878
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Rehabilitation Occupational Therapist
- License
- OT6568
- Practice address
- 1771 Edgewood Ave W Ste 6B
Jacksonville, FL 32208-7208 - Phone
- (904) 768-9966
- Fax
- (904) 367-8760
- NPI assigned
- Apr 6, 2015
- Last updated
- Jul 21, 2022
- 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 |
|---|---|---|---|---|
| Physical Rehabilitation Occupational Therapist | 225XP0019X | OT6568 | FL | Primary |
Addresses
Primary practice location
1771 Edgewood Ave W Ste 6B
Jacksonville, FL 32208-7208
Mailing address
1771 Edgewood Ave W Ste 6B
Jacksonville, FL 32208-7208
Phone (904) 768-9966
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 |
|---|---|---|---|
| OT6568 | FL | MD | Physical Rehabilitation Occupational Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Hana Care Inc. | Past | Accepting new patients | |
| Hana Care Inc | Past | Accepting new patients |
Organizations & group practices 2
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.
-
dba Hana Care Rehab
- Comprehensive Outpatient Rehabilitation Facility (CORF)
- Jacksonville, FL
- NPI 1912084294
-
dba Hana Care Rehab
- Comprehensive Outpatient Rehabilitation Facility (CORF)
- Jacksonville, FL
- NPI 1164891974
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1428278400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1658361600000",
"number": "1801281878",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1771 EDGEWOOD AVE W STE 6B",
"city": "JACKSONVILLE",
"state": "FL",
"postal_code": "322087208",
"telephone_number": "904-768-9966",
"fax_number": "904-367-8760"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1771 EDGEWOOD AVE W STE 6B",
"city": "JACKSONVILLE",
"state": "FL",
"postal_code": "322087208",
"telephone_number": "904-768-9966",
"fax_number": "904-367-8760"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ISSA",
"first_name": "NIEMAT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-04-06",
"last_updated": "2022-07-21",
"status": "A"
},
"taxonomies": [
{
"code": "225XP0019X",
"taxonomy_group": "",
"desc": "Occupational Therapist, Physical Rehabilitation",
"state": "FL",
"license": "OT6568",
"primary": true
}
],
"identifiers": [],
"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 Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.