Active NPI
Beverly L. Seredick, OTD, OTR/L
- Hand Occupational Therapist
- Niceville, FL
National Provider Identifier
1881881779
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Hand Occupational Therapist
- License
- 17913
- Practice address
- 554 Twin Cities Blvd
Niceville, FL 32578-1066 - Phone
- (850) 729-3325
- Fax
- (850) 729-2052
- NPI assigned
- Sep 25, 2007
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Hand Occupational Therapist | 225XH1200X | 056005828 | IL | |
| Hand Occupational Therapist | 225XH1200X | 17913 | FL | Primary |
Addresses
Primary practice location
554 Twin Cities Blvd
Niceville, FL 32578-1066
Mailing address
554 Twin Cities Blvd
Niceville, FL 32578-1066
Phone (850) 729-3325
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 17913 | Other | FL | OT LICENSE |
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 17913 | FL | MD | Hand Occupational Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Barrington Rehabilitation and Sports Physical Therapy LTD | Hand | 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.
-
- Physical Therapist
- Barrington, IL
- NPI 1386736965
Hand
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1190678400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1471305600000",
"number": "1881881779",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "554 TWIN CITIES BLVD",
"city": "NICEVILLE",
"state": "FL",
"postal_code": "325781066",
"telephone_number": "850-729-3325",
"fax_number": "850-729-2052"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "554 TWIN CITIES BLVD",
"city": "NICEVILLE",
"state": "FL",
"postal_code": "325781066",
"telephone_number": "850-729-3325",
"fax_number": "850-729-2052"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SEREDICK",
"first_name": "BEVERLY",
"middle_name": "L.",
"name_prefix": "Dr.",
"credential": "OTD, OTR/L",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-09-25",
"last_updated": "2016-08-16",
"status": "A"
},
"taxonomies": [
{
"code": "225XH1200X",
"taxonomy_group": "",
"desc": "Occupational Therapist, Hand",
"state": "IL",
"license": "056005828",
"primary": false
},
{
"code": "225XH1200X",
"taxonomy_group": "",
"desc": "Occupational Therapist, Hand",
"state": "FL",
"license": "17913",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "OT LICENSE",
"identifier": "17913",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Niceville, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.