Active NPI
Danielle Nystrom
- Occupational Therapist
- Tampa, FL
National Provider Identifier
1861992521
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- OT18989
- Practice address
- 5044 Cypress Trace Dr
Tampa, FL 33624-6910 - Phone
- (813) 924-5276
- NPI assigned
- Feb 19, 2018
- 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 |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | OT18989 | FL | Primary |
Addresses
Primary practice location
5044 Cypress Trace Dr
Tampa, FL 33624-6910
Mailing address
5044 Cypress Trace Dr
Tampa, FL 33624-6910
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 |
|---|---|---|---|
| OT18989 | FL | MD | Occupational Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Go Your Own Way, Inc. | Occupational Therapist | Past | Accepting new patients |
Organizations & group practices 1
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": "1518998400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1518998400000",
"number": "1861992521",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5044 CYPRESS TRACE DR",
"city": "TAMPA",
"state": "FL",
"postal_code": "336246910"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5044 CYPRESS TRACE DR",
"city": "TAMPA",
"state": "FL",
"postal_code": "336246910",
"telephone_number": "813-924-5276"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NYSTROM",
"first_name": "DANIELLE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-02-19",
"last_updated": "2018-02-19",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "FL",
"license": "OT18989",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Tampa, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.