Jazmine Joy-Ann Theodore, OTR/L

Primary specialty

Pediatric Occupational TherapistTaxonomy code 225XP0200X

License

21957 Issued in FL

Practice address

2385 Lawrenceville Hwy Suite B
Decatur, GA 30033-8895

Phone

(404) 289-4270

NPI assigned

Jun 3, 2021

Last updated

May 8, 2023By the provider in NPPES

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

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Progress Village Pediatric Therapy Services

  • Occupational Therapist
  • Decatur, GA
  • NPI 1144593047
  NPD (past)
• Village Pathways Comprehensive Therapy, LLC

  • Speech-Language Pathologist
  • Decatur, GA
  • NPI 1730551219
  NPD (past)
• Premaplay LLC

  • Occupational Therapist
  • Oviedo, FL
  • NPI 1972922821

  Pediatrics

  NPD (past)

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

{
    "created_epoch": "1622678400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1683504000000",
    "number": "1043886617",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1400 MORGAN STANLEY AVE UNIT 433",
            "city": "WINTER PARK",
            "state": "FL",
            "postal_code": "327891990",
            "telephone_number": "516-782-9905"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2385 LAWRENCEVILLE HWY SUITE B",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "300338895",
            "telephone_number": "404-289-4270"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "113 W Chapman Rd",
            "address_purpose": "LOCATION",
            "city": "Oviedo",
            "state": "FL",
            "postal_code": "327658895",
            "country_code": "US",
            "telephone_number": "407-790-5601",
            "fax_number": "407-602-7858",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "THEODORE",
        "first_name": "JAZMINE",
        "middle_name": "JOY-ANN",
        "credential": "OTR/L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-06-03",
        "last_updated": "2023-05-08",
        "certification_date": "2023-05-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "FL",
            "license": "21957",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• The South Atlanta Center for Endocrinology. LLC
• The Steel Mill Inc
• The Up Center, LLC
• The Winn Way Institute Inc
• The Wright Way Consultant LLC
• Therapeutic Outcomes for Self-Sufficiency
• Theresa Schaffer, LLC
• Paul R. Thim, L.M.F.T.
• Rick Davis Thode, PH.D.
• Thomas Eye Group PC

• Pediatric Occupational Therapist in Decatur, GA
• Providers in Decatur, GA by specialty
• Pediatric Occupational Therapist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 2023; 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.