Individual provider Active NPI

Nicholas Jeremy Crotty, OTR/L

  • Occupational Therapist
  • Tarpon Springs, FL
National Provider Identifier
1962642827
Registry record updated Mar 4, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
OT 13547 Issued in FL
Practice address
1396 Ventnor Ave
Tarpon Springs, FL 34689-2731
Phone
(727) 403-9268
Fax
(727) 937-1182
NPI assigned
Mar 4, 2009
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 4, 2009

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 OT 13547 FL Primary

Addresses

Primary practice location

1396 Ventnor Ave
Tarpon Springs, FL 34689-2731

Mailing address

1396 Ventnor Ave
Tarpon Springs, FL 34689-2731
Phone (727) 403-9268

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 2008
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1335 Stranssner Dr
Brentwood, MO 63144-1872

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OT 13547FLMDOccupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1236124800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1236124800000",
    "number": "1962642827",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1396 VENTNOR AVE",
            "city": "TARPON SPRINGS",
            "state": "FL",
            "postal_code": "346892731",
            "telephone_number": "727-403-9268",
            "fax_number": "727-937-1182"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1396 VENTNOR AVE",
            "city": "TARPON SPRINGS",
            "state": "FL",
            "postal_code": "346892731",
            "telephone_number": "727-403-9268",
            "fax_number": "727-937-1182"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CROTTY",
        "first_name": "NICHOLAS",
        "middle_name": "JEREMY",
        "name_prefix": "Mr.",
        "credential": "OTR/L",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-03-04",
        "last_updated": "2009-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "FL",
            "license": "OT 13547",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tarpon Springs, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.