Individual provider Active NPI

Michele K Staudenmaier, OTLR

  • Pediatric Occupational Therapist
  • Lutz, FL
National Provider Identifier
1821284837
Registry record updated Nov 22, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Occupational TherapistTaxonomy code 225XP0200X
License
OT15491 Issued in FL
Practice address
5305 Pagnotta PL
Lutz, FL 33558-8046
Phone
(919) 449-7460
NPI assigned
Sep 24, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 22, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Occupational Therapist 225XP0200X OT15491 FL Primary

Addresses

Primary practice location

5305 Pagnotta PL
Lutz, FL 33558-8046

Mailing address

5305 Pagnotta PL
Lutz, FL 33558-8046
Phone (919) 449-7460

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

LicenseStateTypeSpecialty
OT15491FLMDPediatric Occupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1190592000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1385078400000",
    "number": "1821284837",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5305 PAGNOTTA PL",
            "city": "LUTZ",
            "state": "FL",
            "postal_code": "335588046",
            "telephone_number": "919-449-7460"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5305 PAGNOTTA PL",
            "city": "LUTZ",
            "state": "FL",
            "postal_code": "335588046",
            "telephone_number": "919-449-7460"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STAUDENMAIER",
        "first_name": "MICHELE",
        "middle_name": "K",
        "name_prefix": "Ms.",
        "credential": "OTLR",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-09-24",
        "last_updated": "2013-11-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "FL",
            "license": "OT15491",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lutz, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 22, 2013; 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.