Active NPI
Jillian Meidenbauer, OTR/L
- Occupational Therapist
- Clearwater, FL
National Provider Identifier
1902380421
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 19452
- Practice address
- 4902 Creekside Dr Ste a
Clearwater, FL 33760-4033 - Phone
- (727) 592-9100
- NPI assigned
- Sep 20, 2018
- Last updated
- Sep 20, 2018
- Sex
- Female
- Sole proprietor
- Yes
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 | 19452 | FL | Primary |
Addresses
Primary practice location
4902 Creekside Dr Ste a
Clearwater, FL 33760-4033
Mailing address
4902 Creekside Dr Ste a
Clearwater, FL 33760-4033
Phone (727) 592-9100
Other practice location 1
4902 Creekside Dr Ste A
Clearwater, FL 33760-4033
Phone (727) 592-9100
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 |
|---|---|---|---|
| 19452 | FL | MD | Occupational Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| I.T.S. for Kids, Inc. | Multi-Specialty | 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": "1537401600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1537401600000",
"number": "1902380421",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4902 CREEKSIDE DR STE A",
"city": "CLEARWATER",
"state": "FL",
"postal_code": "337604033",
"telephone_number": "727-592-9100"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4902 CREEKSIDE DR STE A",
"city": "CLEARWATER",
"state": "FL",
"postal_code": "337604033",
"telephone_number": "727-592-9100"
}
],
"practiceLocations": [
{
"address_1": "4902 Creekside Dr Ste A",
"address_purpose": "LOCATION",
"city": "Clearwater",
"state": "FL",
"postal_code": "337604033",
"country_code": "US",
"telephone_number": "727-592-9100",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "MEIDENBAUER",
"first_name": "JILLIAN",
"credential": "OTR/L",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2018-09-20",
"last_updated": "2018-09-20",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "FL",
"license": "19452",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Clearwater, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 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.