Jaclynn Stollfus, MOTR

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

114071 Issued in TX

Practice address

2600 Parkview LN
Bedford, TX 76022-7989

Phone

(817) 857-4302

NPI assigned

Jan 24, 2022

Last updated

Jan 24, 2022By the provider in NPPES

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

Electronic endpoints 1

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": "1642982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1642982400000",
    "number": "1104578814",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2510 KODIAK CIR",
            "city": "EULESS",
            "state": "TX",
            "postal_code": "760396080",
            "telephone_number": "920-217-2007"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2600 PARKVIEW LN",
            "city": "BEDFORD",
            "state": "TX",
            "postal_code": "760227989",
            "telephone_number": "817-857-4302"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STOLLFUS",
        "first_name": "JACLYNN",
        "credential": "MOTR",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-01-24",
        "last_updated": "2022-01-24",
        "certification_date": "2022-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "TX",
            "license": "114071",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Bedford",
            "affiliation": "N",
            "endpointDescription": "SNF",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "2600 Parkview Ln",
            "city": "Bedford",
            "state": "TX",
            "country_code": "US",
            "postal_code": "760227989",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Occupational Therapist in Bedford, TX
• Providers in Bedford, TX by specialty
• Occupational Therapist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2022; 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.