Active NPI
Jessica Lynne Story, OTR/L
- Pediatric Occupational Therapist
- Lewiston, ME
National Provider Identifier
1063518447
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Occupational Therapist
- License
- OT1788
- Practice address
- 15 Strawberry Ave
Lewiston, ME 04240-5941 - Phone
- (207) 330-9236
- NPI assigned
- Sep 15, 2006
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Occupational Therapist | 225XP0200X | |||
| Pediatric Occupational Therapist | 225XP0200X | OT1788 | ME | Primary |
Addresses
Primary practice location
15 Strawberry Ave
Lewiston, ME 04240-5941
Mailing address
11 Hatch Rd
Lisbon, ME 04250-6211
Phone (207) 240-2355
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 418120099 | Medicaid | ME |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in ME
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20250117003017 | ME | Practitioner - Occupational Therapist in Private Practice | 1052840188 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1158278400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1734220800000",
"number": "1063518447",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11 HATCH RD",
"city": "LISBON",
"state": "ME",
"postal_code": "042506211",
"telephone_number": "207-240-2355"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "15 STRAWBERRY AVE",
"city": "LEWISTON",
"state": "ME",
"postal_code": "042405941",
"telephone_number": "207-330-9236"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STORY",
"first_name": "JESSICA",
"middle_name": "LYNNE",
"credential": "OTR/L",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-09-15",
"last_updated": "2024-12-15",
"certification_date": "2024-12-15",
"status": "A"
},
"taxonomies": [
{
"code": "225XP0200X",
"taxonomy_group": "",
"desc": "Occupational Therapist, Pediatrics",
"state": null,
"license": null,
"primary": false
},
{
"code": "225XP0200X",
"taxonomy_group": "",
"desc": "Occupational Therapist, Pediatrics",
"state": "ME",
"license": "OT1788",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "418120099",
"state": "ME"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Lewiston, ME
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.