Individual provider Active NPI

Jessica Ghetes, COTA/L

  • Occupational Therapy Assistant
  • Peoria, AZ
National Provider Identifier
1013325232
Registry record updated Jul 31, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Therapy AssistantTaxonomy code 224Z00000X
License
5905 Issued in AZ
Practice address
26976 N 90TH LN
Peoria, AZ 85383-3759
Phone
(623) 703-7904
Fax
(623) 581-5260
NPI assigned
Jul 31, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 31, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy Assistant 224Z00000X 5905 AZ Primary

Addresses

Primary practice location

26976 N 90TH LN
Peoria, AZ 85383-3759

Mailing address

26976 N 90TH LN
Peoria, AZ 85383-3759
Phone (623) 703-7904

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
5905AZMDOccupational Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1406764800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1406764800000",
    "number": "1013325232",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26976 N 90TH LN",
            "city": "PEORIA",
            "state": "AZ",
            "postal_code": "853833759",
            "telephone_number": "623-703-7904",
            "fax_number": "623-581-5260"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26976 N 90TH LN",
            "city": "PEORIA",
            "state": "AZ",
            "postal_code": "853833759",
            "telephone_number": "623-703-7904",
            "fax_number": "623-581-5260"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GHETES",
        "first_name": "JESSICA",
        "credential": "COTA/L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-07-31",
        "last_updated": "2014-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "AZ",
            "license": "5905",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Peoria, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2014; 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.