Active NPI
Kim Goodwater Bedoya, MOTR/L
- Occupational Therapist
- Tampa, FL
National Provider Identifier
1871865758
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 12910
- Practice address
- 2916 Habana Way
Tampa, FL 33614-3566 - Phone
- (813) 227-4347
- Fax
- (813) 428-6050
- NPI assigned
- Feb 7, 2012
- 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 | 12910 | FL | Primary |
Addresses
Primary practice location
2916 Habana Way
Tampa, FL 33614-3566
Mailing address
10144 Arbor Run Dr
Unit 109
Tampa, FL 33647-3566
Phone (843) 437-2858
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 |
|---|---|---|---|
| 12910 | FL | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1328572800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1328572800000",
"number": "1871865758",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10144 ARBOR RUN DR",
"address_2": "UNIT 109",
"city": "TAMPA",
"state": "FL",
"postal_code": "336473566",
"telephone_number": "843-437-2858",
"fax_number": "813-428-6050"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2916 HABANA WAY",
"city": "TAMPA",
"state": "FL",
"postal_code": "336143566",
"telephone_number": "813-227-4347",
"fax_number": "813-428-6050"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BEDOYA",
"first_name": "KIM",
"middle_name": "GOODWATER",
"credential": "MOTR/L",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-02-07",
"last_updated": "2012-02-07",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "FL",
"license": "12910",
"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 7, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.