Individual provider Active NPI

Jacqueline Reitmayr, OTR/L

  • Occupational Therapist
  • Bradenton, FL
National Provider Identifier
1902172109
Registry record updated Jun 21, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
OT16417 Issued in FL
Practice address
3911 Golf Park Loop
Suite 105
Bradenton, FL 34203-3453
Phone
(941) 756-1003
NPI assigned
Apr 2, 2012
Last updated
Jun 21, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 21, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 63 016042 NY
Occupational Therapist 225X00000X OT16417 FL Primary

Addresses

Primary practice location

3911 Golf Park Loop
Suite 105
Bradenton, FL 34203-3453

Mailing address

235 3Rd Ave N
Unit 235
St Petersburg, FL 33701-3350
Phone (516) 234-4942

Other identifiers 1

IdentifierTypeStateIssuer
013184600MedicaidFL

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
OT16417FLMDOccupational Therapist
63 016042NYMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Children's Therapy Associates, 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1333324800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1466467200000",
    "number": "1902172109",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "235 3RD AVE N",
            "address_2": "UNIT 235",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337013350",
            "telephone_number": "516-234-4942"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3911 GOLF PARK LOOP",
            "address_2": "SUITE 105",
            "city": "BRADENTON",
            "state": "FL",
            "postal_code": "342033453",
            "telephone_number": "941-756-1003"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REITMAYR",
        "first_name": "JACQUELINE",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-04-02",
        "last_updated": "2016-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NY",
            "license": "63 016042",
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "FL",
            "license": "OT16417",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "013184600",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bradenton, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 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.

Verify at the official NPI Registry.