MRS. BEVERLY WALLACE


Address: 3911 Golf Park Loop, Suite #105, Bradenton, FL 34203-3453
Phone: 9417561003

MRS. BEVERLY WALLACE (NPI# 1174595367) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1174595367
Entity Type Individual
Full Name MRS. BEVERLY WALLACE
Credential OTR/L
Practice Address 3911 Golf Park Loop
Suite #105
Bradenton
FL 34203-3453
Mailing Address 6477 Indigo Bunting Pl
Bradenton
FL 34202-8246
Practice Telephone 9417561003
Practice Fax Number 9417566003
Mailing Telephone 9417561003
Mailing Fax Number 9417566003
Enumeration Date 2006-02-02
Last Update Date 2007-07-09
Gender Code F
Is Sole Proprietor X

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 225X00000X Occupational Therapist OT9730 FL Respiratory, Developmental, Rehabilitative and Restorative Service Providers

Other Provider Identifier

State Issuer Identifier Type Code
FL BCBS Y902F 01

Other Providers BEVERLY WALLACE

NPI Name Taxonomy Address Enumeration
1942759238 Beverly Rose Wallace Counselor 3719 Benson Dr, Raleigh, NC 27609-7324 2016-09-27

Office Location

Street Address 3911 GOLF PARK LOOP
SUITE #105
City BRADENTON
State FL
Zip Code 34203-3453

Providers in the same location

NPI Name Taxonomy Address Enumeration
1700857943 Margaret L Byrne Physical Therapist 3911 Golf Park Loop, Suite 105, Bradenton, FL 34203-3453 2006-01-27
1972044725 Emily Parisey Occupational Therapist 3911 Golf Park Loop, 105, Bradenton, FL 34203-3453 2017-03-13
1861945214 Marita Korattiyil Speech-Language Pathologist 3911 Golf Park Loop, Suite 105, Bradenton, FL 34203-3453 2016-08-02
1063886117 Scott William Hardy Contractor 3911 Golf Park Loop, Suite 105, Bradenton, FL 34203-3453 2015-11-30
1235557745 Heather Anacki Speech-Language Pathologist 3911 Golf Park Loop, Bradenton, FL 34203-3453 2014-04-01
1902172109 Jacqueline Reitmayr Occupational Therapist 3911 Golf Park Loop, Suite 105, Bradenton, FL 34203-3453 2012-04-02
1821283474 Family Home Physicians, LLC Specialist 3911 Golf Park Loop, Suite 101, Bradenton, FL 34203-3453 2007-09-06
1245286145 Children's Therapy Associates, Inc Occupational Therapist 3911 Golf Park Loop, Suite #105, Bradenton, FL 34203-3453 2006-05-25
1053383927 Samantha Robinson Occupational Therapist 3911 Golf Park Loop, Suite 105, Bradenton, FL 34203-3453 2006-02-06
1124090311 Donald Boulanger Occupational Therapist 3911 Golf Park Loop, Suite 105, Bradenton, FL 34203-3453 2006-02-02
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Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1063069268 Mcr Health, Inc. Clinic/Center 6040 Sr 70 E, Bradenton, FL 34203 2019-08-22
1053814251 Oneco Smiles Inc Dentist 1612 53rd Ave East, Oneco, FL 34203 2018-03-14
1811404908 Dedicated Senior Medical Center of Florida, LLC Non-Pharmacy Dispensing Site 1505 53rd Ave, Bradenton, FL 34203 2018-01-10
1871003632 Linda J Campbell Dietitian, Registered 6610 68th Street East, Bradenton, FL 34203 2017-10-06
1710430988 Crystal Camden Dentist 5205 Office Park Blvd, Bradenton, FL 34203 2016-07-25
1104214865 Sea of Smiles, Inc. Dentist 6060 State Road 70, Suite A, Bradenton, FL 34203 2015-01-05
1699163808 Florida Medical Specialists LLC Family Medicine 6110 State Road 70 East, Bradenton, FL 34203 2014-12-23
1881090025 Lockwood Commons Dental Care Dentist 4222 53rd Ave E, Bradenton, FL 34203 2014-11-17
1447661418 David W Heaton Dentist 1612 53rd Avenue East, Bradenton, FL 34203 2014-05-13
1346688066 Joshua Donald Hogan Pharmacist 7290 55th Avenue East, Bradenton, FL 34203 2013-06-05
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Taxonomy Information

Taxonomy Code 225X00000X
Grouping Respiratory, Developmental, Rehabilitative and Restorative Service Providers
Classification Occupational Therapist

Taxonomy Definition

An occupational therapist is a person who has graduated from an entry-level occupational therapy program accredited by the Accreditation Council for Occupational Therapy Education (ACOTE) or predecessor organizations, or approved by the World Federation of Occupational Therapists (WFOT), or an equivalent international occupational therapy education program; has successfully completed a period of supervised fieldwork experience required by the occupational therapy program; has passed a nationally recognized entry-level examination for occupational therapists, and fulfills state requirements for licensure, certification, or registration. An occupational therapist provides interventions based on evaluation and which emphasize the therapeutic use of everyday life activities (i.e., occupations) with individuals or groups for the purpose of facilitating participation in roles and situations and in home, school, workplace, community and other settings. Occupational therapy services are provided for the purpose of promoting health and wellness and are provided to those who have or are at risk for developing an illness, injury, disease, disorder, condition, impairment, disability, activity limitation, or participation restriction. Occupational therapists address the physical, cognitive, psychosocial, sensory, and other aspects of occupational performance in a variety of contexts to support engagement in everyday life activities that affect health, well-being, and quality of life.
Notes: Source: The Guide to Occupational Therapy Practice, 2nd edition. Bethesda: American Occupational Therapy Association, 2007. [7/1/2008: definition changed, added source]

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1477163145 Miranda Sue Tipton Occupational Therapist 6210 Glen Abbey Ln, Bradenton, FL 34202-9744 2020-08-06
1568024404 Kristin Maria Dedrick Occupational Therapist 4702 Cortez Rd W, Bradenton, FL 34210-2801 2019-07-01
1649834722 Elizabeth Blair Smith Occupational Therapist 12539 Natureview Cir, Bradenton, FL 34212-2984 2019-04-24
1073073524 Sharon Rodgers Yadven Occupational Therapist 2407 Landings Cir, Bradenton, FL 34209-9675 2019-03-21
1316419583 James Christopher Ennis Occupational Therapist 12580 Natureview Cir, Bradenton, FL 34212-2982 2018-12-27
1629588470 Britnie Melton Occupational Therapist 605 131st St E, Bradenton, FL 34212-9197 2017-10-06
1558892497 Deborah Demello Occupational Therapist 360 46th Ct E, Bradenton, FL 34208-8462 2017-03-22
1558814723 Brent Robert Cheyne Occupational Therapist 3911 Golf Park Loop Ste 105, Bradenton, FL 34203-3453 2016-07-25
1275993099 Kristina Perez Occupational Therapist 872 62nd Street Cir E Ste 102, Bradenton, FL 34208-6238 2016-03-07
1952778847 Shirley Laflamme Occupational Therapist 5507 29th St W, Bradenton, FL 34207-3537 2015-08-26
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Competitor

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City BRADENTON
Zip Code 34203

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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