Renee Talbot, COTA/L

Primary specialty

Community Health WorkerTaxonomy code 172V00000X

License

OTA 13584 Issued in FL

Practice address

8544 Glenbury CT N
Jacksonville, FL 32256-9081

Phone

(941) 704-0210

NPI assigned

Sep 8, 2014

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Renee Mallow Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1410134400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1410134400000",
    "number": "1831590074",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8544 GLENBURY CT N",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322569081",
            "telephone_number": "941-704-0210"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8544 GLENBURY CT N",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322569081",
            "telephone_number": "941-704-0210"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TALBOT",
        "first_name": "RENEE",
        "credential": "COTA/L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-09-08",
        "last_updated": "2014-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "172V00000X",
            "taxonomy_group": "",
            "desc": "Community Health Worker",
            "state": "FL",
            "license": "OTA 13584",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "RENEE",
            "last_name": "MALLOW",
            "credential": "COTA/L",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Dana Take
• Taks Care Group LLC
• William J Talamas
• Sirisha Talari, MD
• Ashley Talbot, M.A., B.S.
• Lindsey Talcott, OTR/L
• Khalil Talib
• Brad Douglas Talley, M.D.
• Nicholas Joseph Talley, M.D.
• Ellen Talos, MD

• Community Health Worker in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Community Health Worker in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2014; 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.