Individual provider Active NPI

Onica Anne Jacobs, OTR/L

  • Gerontology Occupational Therapist
  • Spencer, IA
National Provider Identifier
1003323650
Registry record updated Jan 4, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Occupational TherapistTaxonomy code 225XG0600X
License
089282 Issued in IA
Practice address
1301 Saint Luke Dr
Spencer, IA 51301-6043
Phone
(712) 262-5931
Fax
(712) 262-4743
NPI assigned
Jan 4, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 4, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Occupational Therapist 225XG0600X 089282 IA Primary

Addresses

Primary practice location

1301 Saint Luke Dr
Spencer, IA 51301-6043

Mailing address

141 N 1St Ave W
Hartley, IA 51346-1123
Phone (712) 363-5582

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
089282IAMDGerontology Occupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1515024000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1515024000000",
    "number": "1003323650",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "141 N 1ST AVE W",
            "city": "HARTLEY",
            "state": "IA",
            "postal_code": "513461123",
            "telephone_number": "712-363-5582"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1301 SAINT LUKE DR",
            "city": "SPENCER",
            "state": "IA",
            "postal_code": "513016043",
            "telephone_number": "712-262-5931",
            "fax_number": "712-262-4743"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACOBS",
        "first_name": "ONICA",
        "middle_name": "ANNE",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-01-04",
        "last_updated": "2018-01-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XG0600X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Gerontology",
            "state": "IA",
            "license": "089282",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Spencer, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2018; 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.