Haley Jackson, COTA

Primary specialty

Occupational Therapy AssistantTaxonomy code 224Z00000X

License

18-01524 Issued in KS

Practice address

12100 W 109TH St
Overland Park, KS 66210-1200

Phone

(913) 469-4210

NPI assigned

Mar 10, 2022

Sex

Female

Sole proprietor

No

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

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

{
    "created_epoch": "1646870400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646870400000",
    "number": "1063160992",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "529 SOUTHSHORE DR",
            "city": "LAKE WINNEBAGO",
            "state": "MO",
            "postal_code": "640347815",
            "telephone_number": "913-749-7709"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12100 W 109TH ST",
            "city": "OVERLAND PARK",
            "state": "KS",
            "postal_code": "662101200",
            "telephone_number": "913-469-4210"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "HALEY",
        "credential": "COTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-03-10",
        "last_updated": "2022-03-10",
        "certification_date": "2022-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "KS",
            "license": "18-01524",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jeremy R Jabara, DPT
• Alexis Jacey, ATC
• Meggan Marie Jacks, D.C.
• Jami Tei Jackson Schraeder, D.O.
• Adrian P Jackson, M.D.
• Randall Jackson
• Robert Vincent Jackson, M.D.
• Victoria Jackson
• Bailey Jacobs
• Callie Jacobs, PTA

• Occupational Therapy Assistant in Overland Park, KS
• Providers in Overland Park, KS by specialty
• Occupational Therapy Assistant in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2022; 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.