SALLY ERICKSEN (NPI# 1750475083) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1750475083 |
| Entity Type | Individual |
| Full Name | SALLY ERICKSEN |
| Credential | OT |
| Practice Address |
540 Kingsley Ave Orange Park FL 32073-4847 |
| Mailing Address |
2194 Lakeside Dr E Fernandina Beach FL 32034-5232 |
| Practice Telephone | 9042642156 |
| Mailing Telephone | 9042612329 |
| Enumeration Date | 2006-10-03 |
| Last Update Date | 2007-07-08 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 225X00000X | Occupational Therapist | OT77 | FL | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | 8873658000 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528375284 | Sally Mae Ericksen | Nurse Practitioner | 5814 Graham Ave Ste 100, Sumner, WA 98390-2728 | 2010-09-01 |
| Street Address |
540 KINGSLEY AVE |
| City | ORANGE PARK |
| State | FL |
| Zip Code | 32073-4847 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679546212 | Garry Gillis | Specialist/Technologist | 540 Kingsley Ave, Orange Park, FL 32073-4847 | 2006-02-13 |
| 1033241427 | Christopher Nuetzi | Physical Therapy Assistant | 540 Kingsley Ave, Orange Park, FL 32073-4847 | 2007-03-12 |
| 1477697407 | Heartland Rehabilitation Services of Florida LLC | Clinic/Center | 540 Kingsley Ave, Orange Park, FL 32073-4847 | 2007-02-15 |
| 1235218447 | Shannon White | Physical Therapist | 540 Kingsley Ave, Orange Park, FL 32073-4847 | 2006-11-06 |
| 1487732905 | Jeffery Leroux | Specialist/Technologist | 540 Kingsley Ave, Orange Park, FL 32073-4847 | 2006-11-01 |
| 1891873311 | Shawn Wolf | Specialist/Technologist | 540 Kingsley Ave, Orange Park, FL 32073-4847 | 2006-11-01 |
| 1063590594 | Julie Marie Tribett | Specialist/Technologist | 540 Kingsley Ave, Orange Park, FL 32073-4847 | 2006-11-01 |
| 1033297569 | Christine Adams | Specialist/Technologist | 540 Kingsley Ave, Orange Park, FL 32073-4847 | 2006-11-01 |
| 1912085440 | Amethyst Mann | Specialist/Technologist | 540 Kingsley Ave, Orange Park, FL 32073-4847 | 2006-11-01 |
| 1851475883 | Gretchen Martin | Physical Therapy Assistant | 540 Kingsley Ave, Orange Park, FL 32073-4847 | 2006-10-25 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891309423 | Kingsley Endoscopy Center LLC | Clinic/Center | 970 Kingsley Avenue, Orange Park, FL 32073 | 2020-09-01 |
| 1962028688 | Esra Sari | Student in an Organized Health Care Education/Training Program | 2001 Kingsley Avenue., Orange Park Medical Center, Orange Park, FL 32073 | 2020-06-18 |
| 1104441146 | Zeshan Tariq Malik | Student in an Organized Health Care Education/Training Program | 2001 Kingsley Avenue, Office of Graduate Medical Educa, Orange Park, FL 32073 | 2020-06-16 |
| 1902421894 | Ameer Hamza | Student in an Organized Health Care Education/Training Program | 2001, Kingsley Avenue Office of Graduate Medical Educat, Orange Park, FL 32073 | 2020-06-16 |
| 1497378103 | Fawad Ahmed Rashid | Student in an Organized Health Care Education/Training Program | 2001 Kingsley Avenue Office of Graduate Medical Educati, Orange Park, FL 32073 | 2020-05-28 |
| 1477174985 | Hannan Asghar | Student in an Organized Health Care Education/Training Program | Office of Graduate Medical Education 2001 Kingsley, Orange Park, FL 32073 | 2020-05-06 |
| 1902427156 | Emmanuel Iyanuloluwa Morakinyo | Student in an Organized Health Care Education/Training Program | 413 Deer View Avenue, 2001 Kingsley Ave, Orange Park, FL 32073 | 2020-04-29 |
| 1437799327 | Dalande Leger | Behavior Technician | 1563 Kingsley Ave Suite 103, Orange Park, FL 32073 | 2020-01-08 |
| 1215598313 | Mohammad Harisullah Khan | Student in an Organized Health Care Education/Training Program | 2001 Kingsley Ave, Gme Office, Orange Park, FL 32073 | 2019-06-28 |
| 1558927970 | Preetha Kamath | Student in an Organized Health Care Education/Training Program | Orange Park Medical Center, 2001 Kingsley Ave, Orange Park, FL 32073 | 2019-05-10 |
| Find all providers in zip 32073 | ||||
| Taxonomy Code | 225X00000X |
| Grouping | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Classification | Occupational Therapist |
| 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] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760925325 | Denise Draper | Occupational Therapist | 350 Corporate Way, 250, Orange Park, FL 32073-2874 | 2016-11-29 |
| 1811313083 | Derian Anderson | Occupational Therapist | 2325 Torbay Dr, Orange Park, FL 32073-4278 | 2014-03-12 |
| 1689915308 | Colette Y Freda | Occupational Therapist | 3680 Middlebrook Dr, Orange Park, FL 32065-5543 | 2013-03-05 |
| 1841560133 | Nicole Hallick | Occupational Therapist | 2673 Admirals Walk Dr. E, Orange Park, FL 32073 | 2012-01-04 |
| 1578739975 | Kristopher Edward Wilson | Occupational Therapist | 1675 Eagle Harbor Pkwy, Suite B, Orange Park, FL 32003-4802 | 2008-05-06 |
| 1124208145 | Cassie Grant | Occupational Therapist | 261 Eventide Dr, Orange Park, FL 32003-8187 | 2007-11-07 |
| 1861690885 | Jacqueline Jean Conroy | Occupational Therapist | 1835 Commodore Point Dr, Orange Park, FL 32003-7206 | 2007-07-11 |
| 1366588006 | Joan Theresa Warren | Occupational Therapist | 1232 Harbour Town Dr, Orange Park, FL 32065-2562 | 2007-01-29 |
| 1548892771 | Zachary Perry | Occupational Therapist | 500 Park Ave, Orange Park, FL 32073-3132 | 2020-02-05 |
| 1942777057 | Janet Wilbanks | Occupational Therapist | 155 Blanding Blvd, Orange Park, FL 32073-2630 | 2018-10-26 |
| Find all providers in ORANGE PARK | ||||
| City | ORANGE PARK |
| Zip Code | 32073 |
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| 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.