Active NPI
Nicole Latham
- Occupational Therapist
- Gulf Breeze, FL
National Provider Identifier
1942997374
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- OT21917
- Practice address
- 4410 Gulf Breeze Pkwy
Gulf Breeze, FL 32563-8130 - Phone
- (850) 749-5215
- NPI assigned
- Apr 18, 2023
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | OT21917 | FL | Primary |
Addresses
Primary practice location
4410 Gulf Breeze Pkwy
Gulf Breeze, FL 32563-8130
Mailing address
229 E Highland Dr
Pensacola, FL 32503-3073
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
| License | State | Type | Specialty |
|---|---|---|---|
| OT21917 | FL | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1681776000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1681776000000",
"number": "1942997374",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "229 E HIGHLAND DR",
"city": "PENSACOLA",
"state": "FL",
"postal_code": "325033073"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4410 GULF BREEZE PKWY",
"city": "GULF BREEZE",
"state": "FL",
"postal_code": "325638130",
"telephone_number": "850-749-5215"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LATHAM",
"first_name": "NICOLE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-04-18",
"last_updated": "2023-04-18",
"certification_date": "2023-04-17",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "FL",
"license": "OT21917",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Gulf Breeze, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.