Jessica Marie Taylor, OTD, OTRL

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

5201007567 Issued in MI

Practice address

1524 Portabella TRL
Mt Pleasant, MI 48858-4006

Phone

(989) 772-2967

Fax

(989) 779-9060

NPI assigned

Feb 1, 2012

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Ms. Jessica Marie Black 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": "1328054400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1382918400000",
    "number": "1104198423",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1495 W FLECK RD",
            "city": "SIX LAKES",
            "state": "MI",
            "postal_code": "488869544",
            "telephone_number": "989-287-0023"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1524 PORTABELLA TRL",
            "city": "MT PLEASANT",
            "state": "MI",
            "postal_code": "488584006",
            "telephone_number": "989-772-2967",
            "fax_number": "989-779-9060"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAYLOR",
        "first_name": "JESSICA",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "OTD, OTRL",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-02-01",
        "last_updated": "2013-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "MI",
            "license": "5201007567",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JESSICA",
            "last_name": "BLACK",
            "middle_name": "MARIE",
            "prefix": "MS.",
            "credential": "OTRL",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Anjle Tank
• Corey Jo Tarbell, PA-C
• Pamela J Tarras, ARNP
• Dylan D Tasson, DPT
• Renny Hemsley Tatchell, PHD, CCC-SLP
• Kristen Marie Telfor, NP-C
• Mickki Renae Templeman, CFNP
• Ten Sixteen Recovery Network
• Tendercare Michigan Inc.
• Terry Ball DO PLLC

• Occupational Therapist in Mt Pleasant, MI
• Providers in Mt Pleasant, MI by specialty
• Occupational Therapist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2013; 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.