Individual provider Active NPI

Angie Bacon Lopresti, ITDS

  • Developmental Therapist
  • Saint Augustine, FL
National Provider Identifier
1992387872
Registry record updated Apr 21, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Developmental TherapistTaxonomy code 222Q00000X
Practice address
1 Ocean Trace Rd Unit 112
Saint Augustine, FL 32080-6977
Phone
(251) 605-5834
NPI assigned
Apr 21, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 21, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Developmental Therapist 222Q00000X FL Primary

Addresses

Primary practice location

1 Ocean Trace Rd Unit 112
Saint Augustine, FL 32080-6977

Mailing address

1 Ocean Trace Rd Unit 112
Saint Augustine, FL 32080-6977
Phone (251) 605-5834

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

NPI Registry JSON

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

{
    "created_epoch": "1618963200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1618963200000",
    "number": "1992387872",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 OCEAN TRACE RD UNIT 112",
            "city": "SAINT AUGUSTINE",
            "state": "FL",
            "postal_code": "320806977",
            "telephone_number": "251-605-5834"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 OCEAN TRACE RD UNIT 112",
            "city": "SAINT AUGUSTINE",
            "state": "FL",
            "postal_code": "320806977",
            "telephone_number": "251-605-5834"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOPRESTI",
        "first_name": "ANGIE",
        "middle_name": "BACON",
        "credential": "ITDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-04-21",
        "last_updated": "2021-04-21",
        "certification_date": "2021-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "222Q00000X",
            "taxonomy_group": "",
            "desc": "Developmental Therapist",
            "state": "FL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Augustine, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 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.