Individual provider Active NPI

Jaime Serrago, OTA

  • Occupational Therapy Assistant
  • Cape Coral, FL
National Provider Identifier
1922491406
Registry record updated Mar 9, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Therapy AssistantTaxonomy code 224Z00000X
License
OTA13568 Issued in FL
Practice address
216 Santa Barbara Blvd
Cape Coral, FL 33991-2031
Phone
(239) 772-4600
NPI assigned
Mar 9, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 9, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy Assistant 224Z00000X OTA13568 FL Primary

Addresses

Primary practice location

216 Santa Barbara Blvd
Cape Coral, FL 33991-2031

Mailing address

216 Santa Barbara Blvd
Cape Coral, FL 33991-2031
Phone (239) 772-4600

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
OTA13568FLMDOccupational Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1425859200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1425859200000",
    "number": "1922491406",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "216 SANTA BARBARA BLVD",
            "city": "CAPE CORAL",
            "state": "FL",
            "postal_code": "339912031",
            "telephone_number": "239-772-4600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "216 SANTA BARBARA BLVD",
            "city": "CAPE CORAL",
            "state": "FL",
            "postal_code": "339912031",
            "telephone_number": "239-772-4600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SERRAGO",
        "first_name": "JAIME",
        "credential": "OTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-03-09",
        "last_updated": "2015-03-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "FL",
            "license": "OTA13568",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cape Coral, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 9, 2015; 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.