Detra Shauntel Simpo, OTR/L is a
Occupational Therapist based in St Johns, Florida. Detra Shauntel Simpo is licensed to practice in Florida (license number OT9940) and her current practice location is
518 Dry Branch Way, St Johns, Florida. She can be reached at her office (for appointments etc.) via phone at
(904) 382-7886.
NPI number for Detra Shauntel Simpo is 1710071220 and her current mailing address is 518 Dry Branch Way, St Johns, Florida. She
does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1710071220.
Healthcare Provider's Profile
Full Name | Detra Shauntel Simpo |
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Gender | Female |
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Speciality | Occupational Therapist |
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Location | 518 Dry Branch Way, St Johns, Florida |
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Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
NPI Data:
- NPI Number: 1710071220
- Provider Enumeration Date: 10/02/2006
- Last Update Date: 09/01/2020
Medical Identifiers
Medical identifiers for Detra Shauntel Simpo such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1710071220 | NPI | - | NPPES |
Z9346 | Other | FL | BCBS |
024815600 | Medicaid | FL | |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
225X00000X | Occupational Therapist | OT9940 (Florida) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Detra Shauntel Simpo is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Detra Shauntel Simpo, OTR/L 518 Dry Branch Way, St Johns, FL 32259-6203 Ph: (904) 382-7886 | Detra Shauntel Simpo, OTR/L 518 Dry Branch Way, St Johns, FL 32259-6203 Ph: (904) 382-7886 |
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