MR. CHARLES HOLLOWAY BOARDMAN IV OTR
NPI 1164417895
Occupational Therapist in Lake City, FL

Active since September 19, 2005
619 SOUTH MARION AVE, NORTH FLORIDA / SOUTH GEORGIA VETERANS HEALTH SYSTEM, LAKE CITY, FL 32025(386) 755-3016 Get Directions Write a Review

NPPES record last updated: February 25, 2012. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Mr. Charles Holloway Boardman Iv Otr NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MR. CHARLES HOLLOWAY BOARDMAN IV OTR (NPI 1164417895) is an individual occupational therapist in Lake City, Florida, licensed in Florida (OT14416FL) and active in the NPI registry since September 2005.

NPPES Registry Identity

NPI1164417895
Entity TypeIndividualMale
Primary Taxonomy225X00000X
Provider Legal NameMR. CHARLES HOLLOWAY BOARDMAN IVCredential: OTR
Location Address619 SOUTH MARION AVE, NORTH FLORIDA / SOUTH GEORGIA VETERANS HEALTH SYSTEMLake City, FL 32025
Mailing Address355 Sw Sweetbreeze DrLake City, FL 32024-3698 · (386) 755-3016
Sole ProprietorNo
Enumeration DateSeptember 19, 2005
Last NPPES UpdateFebruary 25, 2012
NPI 1164417895 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyOccupational TherapistRespiratory, Developmental, Rehabilitative and Restorative Service Providers
Taxonomy Code225X00000X
License Licensed in FL · OT14416FL
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.
619 SOUTH MARION AVE, Lake City, FL 32025

Other Identifiers 2

OtherOT14416FLFL · Florida Department Of Health
OtherAA499343Nbcot

Other Providers at the Same Location NPPES 5

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Pharmacist
619 SOUTH MARION AVE
LAKE CITY, FL 32025
Family Medicine
619 SOUTH MARION AVE
LAKE CITY, FL 32025
Family Medicine
619 SOUTH MARION AVE, VA HOSPITAL
LAKE CITY, FL 32025
Internal Medicine
619 SOUTH MARION AVE, VAMC - LAKE CITY
LAKE CITY, FL 32025
Department of Veterans Affairs (VA) Pharmacy
619 SOUTH MARION AVE
LAKE CITY, FL 32025

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Charles Boardman's NPI number?

The NPI number for Charles Boardman is 1164417895. It was assigned to this individual provider in the NPPES registry on September 19, 2005.

Where is Charles Boardman located?

Charles Boardman practices at 619 South Marion Ave North Florida / South Georgia Veterans Health System, Lake City, FL 32025. The listed phone number is (386) 755-3016.

What is Charles Boardman's specialty?

The primary specialty registered for this NPI is Occupational Therapist with taxonomy code 225X00000X.

When was this NPI record last updated?

The NPPES record for Charles Boardman was last updated on February 25, 2012. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.