Jessica Marie Metcalf, COTA

Primary specialty

Occupational Therapy AssistantTaxonomy code 224Z00000X

License

212615 Issued in TX

Practice address

721 Dunaway LN # NA
Azle, TX 76020-2605

Phone

(817) 444-2536

NPI assigned

Jan 23, 2019

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

Other identifiers 1

Other names 1

• Jessica Marie Metcalf Former name

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": "1548201600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1548201600000",
    "number": "1063976199",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "721 DUNAWAY LN",
            "city": "AZLE",
            "state": "TX",
            "postal_code": "760202605"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "721 DUNAWAY LN # NA",
            "city": "AZLE",
            "state": "TX",
            "postal_code": "760202605",
            "telephone_number": "817-444-2536"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "METCALF",
        "first_name": "JESSICA",
        "middle_name": "MARIE",
        "credential": "COTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-01-23",
        "last_updated": "2019-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "TX",
            "license": "212615",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COTA LICENSE",
            "identifier": "212615",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JESSICA",
            "last_name": "METCALF",
            "middle_name": "MARIE",
            "credential": "RODGERS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Jennifer Ann Moore, PTA

• Occupational Therapy Assistant in Azle, TX
• Providers in Azle, TX by specialty
• Occupational Therapy Assistant in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2019; 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.