Individual provider Active NPI

Jill Desmond, C.O.T.A./L

  • Occupational Therapy Assistant
  • Pomaria, SC
National Provider Identifier
1003244633
Registry record updated Oct 16, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Therapy AssistantTaxonomy code 224Z00000X
License
3219 Issued in SC
Practice address
113 Ryans Gate Rd
Pomaria, SC 29126-8663
Phone
(352) 302-4320
NPI assigned
Oct 16, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 16, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy Assistant 224Z00000X 3219 SC Primary
Occupational Therapy Assistant 224Z00000X 11359 FL

Addresses

Primary practice location

113 Ryans Gate Rd
Pomaria, SC 29126-8663

Mailing address

113 Ryans Gate Rd
Pomaria, SC 29126-8663
Phone (352) 302-4320

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

State licenses

LicenseStateTypeSpecialty
3219SCMDGeneral Practice Dentistry
11359FLMDOccupational Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1381881600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1381881600000",
    "number": "1003244633",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "113 RYANS GATE RD",
            "city": "POMARIA",
            "state": "SC",
            "postal_code": "291268663",
            "telephone_number": "352-302-4320"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "113 RYANS GATE RD",
            "city": "POMARIA",
            "state": "SC",
            "postal_code": "291268663",
            "telephone_number": "352-302-4320"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DESMOND",
        "first_name": "JILL",
        "credential": "C.O.T.A./L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-10-16",
        "last_updated": "2013-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "SC",
            "license": "3219",
            "primary": true
        },
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "FL",
            "license": "11359",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pomaria, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2013; 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.