Active NPI
Sallie Gardner Metcalf, OTR/L
- Occupational Therapist
- Jackson, MS
National Provider Identifier
1023618444
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- OT3793
- Practice address
- 1225 N State St Ste 210
Jackson, MS 39202-2064 - Phone
- (662) 242-0377
- NPI assigned
- Oct 26, 2020
- Last updated
- Oct 28, 2020
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | OT3793 | MS | Primary |
Addresses
Primary practice location
1225 N State St Ste 210
Jackson, MS 39202-2064
Mailing address
965 Ridge Lake Blvd Ste 103
Memphis, TN 38120-9446
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| OT3793 | MS | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1603670400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1603843200000",
"number": "1023618444",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "965 RIDGE LAKE BLVD STE 103",
"city": "MEMPHIS",
"state": "TN",
"postal_code": "381209446",
"fax_number": "901-227-8591"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1225 N STATE ST STE 210",
"city": "JACKSON",
"state": "MS",
"postal_code": "392022064",
"telephone_number": "662-242-0377"
}
],
"practiceLocations": [],
"basic": {
"last_name": "METCALF",
"first_name": "SALLIE",
"middle_name": "GARDNER",
"name_prefix": "Mrs.",
"credential": "OTR/L",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-10-26",
"last_updated": "2020-10-28",
"certification_date": "2020-10-28",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "MS",
"license": "OT3793",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Jackson, MS
- Kathleen A. Messenger, M.D.
- Metamorphosis Rehabilitation LLC (Metamorphosis Rehabilitation)
- Metamorphosis Rehabilitation, LLC
- Metamorphosis Rehabilitation, LLC
- Allen Max Metcalf, D.D.S.
- Methodist Children's Homes
- Methodist Children's Homes
- Methodist Children's Homes
- Methodist Home Road Assisted Living
- Methodist Home Road Living Center
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.