Active NPI
Jessica L Delvacchio, DROT, OTR/L
- Occupational Therapist
- Minot, ND
National Provider Identifier
1053955864
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 1724
- Practice address
- 101 3Rd Ave SW Ste 102
Minot, ND 58701-3880 - Phone
- (701) 857-5286
- Fax
- (701) 857-5694
- NPI assigned
- Nov 5, 2019
- 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 | 1724 | ND | Primary |
Addresses
Primary practice location
101 3Rd Ave SW Ste 102
Minot, ND 58701-3880
Mailing address
PO Box 5020
Minot, ND 58702-5020
Phone (701) 857-5286
Other names 1
- Jessica L Vitale
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
| License | State | Type | Specialty |
|---|---|---|---|
| 1724 | ND | MD | Addiction (Substance Use Disorder) Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1572912000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1595548800000",
"number": "1053955864",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 5020",
"city": "MINOT",
"state": "ND",
"postal_code": "587025020",
"telephone_number": "701-857-5286",
"fax_number": "701-857-5694"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "101 3RD AVE SW STE 102",
"city": "MINOT",
"state": "ND",
"postal_code": "587013880",
"telephone_number": "701-857-5286",
"fax_number": "701-857-5694"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DELVACCHIO",
"first_name": "JESSICA",
"middle_name": "L",
"credential": "DROT, OTR/L",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-11-05",
"last_updated": "2020-07-24",
"certification_date": "2020-07-24",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "ND",
"license": "1724",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "JESSICA",
"last_name": "VITALE",
"middle_name": "L",
"credential": "DROT, OTR/L",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Minot, ND
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 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.