Individual provider Active NPI

Christine Marie Garrett, COTA

  • Occupational Therapy Assistant
  • Jacksonville, FL
National Provider Identifier
1982363420
Registry record updated Dec 13, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Therapy AssistantTaxonomy code 224Z00000X
License
OTA18357 Issued in FL
Practice address
997 Atlantic Blvd
Jacksonville, FL 32233-3311
Phone
(904) 647-1849
NPI assigned
Dec 13, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 13, 2021

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 OTA18357 FL Primary

Addresses

Primary practice location

997 Atlantic Blvd
Jacksonville, FL 32233-3311

Mailing address

331 Sweet Oak Way
St Augustine, FL 32095-8999
Phone (757) 636-8065

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
OTA18357FLMDOccupational Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Bloom Behavioral Solutions, Inc. CurrentSince Jan 19, 2025 Accepting new patients
Bloom Behavioral Solutions CurrentSince Jan 19, 2025 Accepting new patients

Locations

997 Atlantic Blvd
Jacksonville, FL 32233
Phone (904) 647-1849

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": "1639353600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639353600000",
    "number": "1982363420",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "331 SWEET OAK WAY",
            "city": "ST AUGUSTINE",
            "state": "FL",
            "postal_code": "320958999",
            "telephone_number": "757-636-8065"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "997 ATLANTIC BLVD",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322333311",
            "telephone_number": "904-647-1849"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GARRETT",
        "first_name": "CHRISTINE",
        "middle_name": "MARIE",
        "credential": "COTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-12-13",
        "last_updated": "2021-12-13",
        "certification_date": "2021-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "FL",
            "license": "OTA18357",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2021; 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.