Jacqueline C Hostetler, OTRL

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

OT004490 Issued in GA

Practice address

30 Nicklaus Dr NW
Rome, GA 30165-9518

Phone

(706) 346-4666

Fax

(706) 232-9303

NPI assigned

Jan 15, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Pediatric OT Connections Inc

  • Occupational Therapist
  • Rome, GA
  • NPI 1922830066
  NPD Authorized official
• Pediatric OT Connections

  • Pediatric Occupational Therapist
  • Rome, GA
  • NPI 1316852338
  NPD (past) Authorized official

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

{
    "created_epoch": "1168819200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1472774400000",
    "number": "1043361280",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 NICKLAUS DR NW",
            "city": "ROME",
            "state": "GA",
            "postal_code": "301659518",
            "telephone_number": "706-346-4666",
            "fax_number": "706-232-9303"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 NICKLAUS DR NW",
            "city": "ROME",
            "state": "GA",
            "postal_code": "301659518",
            "telephone_number": "706-346-4666",
            "fax_number": "706-232-9303"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOSTETLER",
        "first_name": "JACQUELINE",
        "middle_name": "C",
        "credential": "OTRL",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-15",
        "last_updated": "2016-09-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "GA",
            "license": "OT004490",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "777866008C",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lora Hopper
• Hortman Carney Dental, Inc.
• Jane Hortman, MA, LPC
• Robert P Hortman, DMD
• Kari Winifred Hosford, BCBA
• John Stuart Hostetler, MD
• George Pittman Hotz, M.D.
• Ruma Houghton, MD
• Mary Beth Housch
• Raymond Howard III, M.D.

• Occupational Therapist in Rome, GA
• Providers in Rome, GA by specialty
• Occupational Therapist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2016; 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.