Individual provider Active NPI

Jessie-Lynn Kelley Myers, OTR/L

  • Occupational Therapist
  • Tifton, GA
National Provider Identifier
1083231567
Registry record updated Jun 30, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
OT007776 Issued in GA
Practice address
1488 Old Ocilla Rd
Tifton, GA 31794-4152
Phone
(229) 386-5200
NPI assigned
Jun 30, 2020
Last updated
Jun 30, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 30, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X OT007776 GA Primary

Addresses

Primary practice location

1488 Old Ocilla Rd
Tifton, GA 31794-4152

Mailing address

1298 Ed Lindsey Rd
Lenox, GA 31637-4928
Phone (386) 590-6194

Other practice location 1

1401 US Highway 41 N
Tifton, GA 31794-3203
Phone (229) 387-8377

Other practice location 2

808 Ward St W
Douglas, GA 31533-3514
Phone (912) 383-0559

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

LicenseStateTypeSpecialty
OT007776GAMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
The Lymphedema Center, LLC PastSince Apr 6, 2025 Accepting new patients
Orthopedic and Sports Physical Therapy, Inc. PastSince Jul 5, 2020 Accepting new patients
Rehabilitation Services of Coffee, Inc Occupational Therapist Past Accepting new patients
Rehabilitation Services of Tifton, Inc. Occupational Therapist PastSince Jul 5, 2020 Accepting new patients

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1593475200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1593475200000",
    "number": "1083231567",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1298 ED LINDSEY RD",
            "city": "LENOX",
            "state": "GA",
            "postal_code": "316374928",
            "telephone_number": "386-590-6194"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1488 OLD OCILLA RD",
            "city": "TIFTON",
            "state": "GA",
            "postal_code": "317944152",
            "telephone_number": "229-386-5200"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1401 US Highway 41 N",
            "address_purpose": "LOCATION",
            "city": "Tifton",
            "state": "GA",
            "postal_code": "317943203",
            "country_code": "US",
            "telephone_number": "229-387-8377",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "808 Ward St W",
            "address_purpose": "LOCATION",
            "city": "Douglas",
            "state": "GA",
            "postal_code": "315333514",
            "country_code": "US",
            "telephone_number": "912-383-0559",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MYERS",
        "first_name": "JESSIE-LYNN",
        "middle_name": "KELLEY",
        "name_prefix": "Mrs.",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-06-30",
        "last_updated": "2020-06-30",
        "certification_date": "2020-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "GA",
            "license": "OT007776",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tifton, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 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.

Verify at the official NPI Registry.