Individual provider Active NPI

Jerry Joe Coverdale, OT, CHT

  • Occupational Therapist
  • Delray Beach, FL
National Provider Identifier
1942587019
Registry record updated Nov 3, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
OT2106 Issued in FL
Practice address
4800 Linton Blvd
A201
Delray Beach, FL 33445-6584
Phone
(561) 496-6622
Fax
(561) 496-3835
NPI assigned
Nov 3, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 3, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X OT2106 FL Primary

Addresses

Primary practice location

4800 Linton Blvd
A201
Delray Beach, FL 33445-6584

Mailing address

4800 Linton Blvd
A201
Delray Beach, FL 33445-6584
Phone (561) 496-6622

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
OT2106FLMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Tropical Palms Hand Therapy, Inc Past Accepting new patients
Tropical Palms Hand Therapy Inc Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1320278400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1320278400000",
    "number": "1942587019",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4800 LINTON BLVD",
            "address_2": "A201",
            "city": "DELRAY BEACH",
            "state": "FL",
            "postal_code": "334456584",
            "telephone_number": "561-496-6622",
            "fax_number": "561-496-3835"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4800 LINTON BLVD",
            "address_2": "A201",
            "city": "DELRAY BEACH",
            "state": "FL",
            "postal_code": "334456584",
            "telephone_number": "561-496-6622",
            "fax_number": "561-496-3835"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COVERDALE",
        "first_name": "JERRY",
        "middle_name": "JOE",
        "name_prefix": "Mr.",
        "credential": "OT, CHT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-11-03",
        "last_updated": "2011-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "FL",
            "license": "OT2106",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Delray Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2011; 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.