Active NPI
Jessica Kuebel, COTA/L
- Occupational Therapy Assistant
- Dallas, TX
National Provider Identifier
1093182735
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapy Assistant
- License
- 057.004336
- Practice address
- 9441 LBJ Fwy
Suite 602
Dallas, TX 75243-4545 - Phone
- (469) 249-1883
- NPI assigned
- Aug 28, 2015
- Last updated
- Aug 28, 2015
- 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 Therapy Assistant | 224Z00000X | 057.004336 | IL | Primary |
Addresses
Primary practice location
9441 LBJ Fwy
Suite 602
Dallas, TX 75243-4545
Mailing address
305 2ND Ave N
Albany, IL 61230
Phone (815) 973-7899
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 |
|---|---|---|---|
| 057.004336 | IL | MD | Occupational Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1440720000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1440720000000",
"number": "1093182735",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "305 2ND AVE N",
"city": "ALBANY",
"state": "IL",
"postal_code": "61230",
"telephone_number": "815-973-7899"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9441 LBJ FWY",
"address_2": "SUITE 602",
"city": "DALLAS",
"state": "TX",
"postal_code": "752434545",
"telephone_number": "469-249-1883"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KUEBEL",
"first_name": "JESSICA",
"name_prefix": "Mrs.",
"credential": "COTA/L",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-08-28",
"last_updated": "2015-08-28",
"status": "A"
},
"taxonomies": [
{
"code": "224Z00000X",
"taxonomy_group": "",
"desc": "Occupational Therapy Assistant",
"state": "IL",
"license": "057.004336",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Dallas, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.