Jaime Allison Tickett, BS

Primary specialty

Developmental TherapistTaxonomy code 222Q00000X

Practice address

2951 Tangerine Ter
Palm Harbor, FL 34684-4040

Phone

(727) 224-3800

Fax

(727) 734-3192

NPI assigned

Mar 23, 2007

Last updated

Feb 27, 2019By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Bachelor of Science

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

{
    "created_epoch": "1174608000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1551225600000",
    "number": "1811014913",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2041 SCOTLAND DR",
            "city": "CLEARWATER",
            "state": "FL",
            "postal_code": "337631338",
            "telephone_number": "727-734-3192",
            "fax_number": "727-734-3192"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2951 TANGERINE TER",
            "city": "PALM HARBOR",
            "state": "FL",
            "postal_code": "346844040",
            "telephone_number": "727-224-3800",
            "fax_number": "727-734-3192"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TICKETT",
        "first_name": "JAIME",
        "middle_name": "ALLISON",
        "name_prefix": "Mrs.",
        "credential": "BS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-23",
        "last_updated": "2019-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "222Q00000X",
            "taxonomy_group": "",
            "desc": "Developmental Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "765652100",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Developmental Therapist in Palm Harbor, FL
• Providers in Palm Harbor, FL by specialty
• Developmental Therapist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2019; 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.