NPIMap

Individual provider Active NPI

Jacqueline Ann Proffitt Seidl, OTR/L

  • Occupational Therapist
  • Kailua, HI
National Provider Identifier
1013180983
Registry record updated Apr 10, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
OT-725 Issued in HI
Practice address
2201 Bauer Dr
Kailua, HI 96734-4814
Phone
(808) 638-2892
NPI assigned
Apr 10, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 10, 2008

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X OT-725 HI Primary
Occupational Therapist 225X00000X 4529-026 WI
Occupational Therapist 225X00000X 0119004197 VA

Addresses

Primary practice location

2201 Bauer Dr
Kailua, HI 96734-4814

Mailing address

2201 Bauer Dr
Kailua, HI 96734-4814
Phone (808) 638-2892

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
OT-725HIMDOccupational Therapist
0119004197VAMDOccupational Therapist
4529-026WIMDOccupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1207785600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1207785600000",
    "number": "1013180983",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2201 BAUER DR",
            "city": "KAILUA",
            "state": "HI",
            "postal_code": "967344814",
            "telephone_number": "808-638-2892"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2201 BAUER DR",
            "city": "KAILUA",
            "state": "HI",
            "postal_code": "967344814",
            "telephone_number": "808-638-2892"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SEIDL",
        "first_name": "JACQUELINE",
        "middle_name": "ANN PROFFITT",
        "credential": "OTR/L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-04-10",
        "last_updated": "2008-04-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "HI",
            "license": "OT-725",
            "primary": true
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "WI",
            "license": "4529-026",
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "VA",
            "license": "0119004197",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kailua, HI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 2008; 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.