Individual provider Active NPI

Mary Colette Jewell, OT

  • Specialist
  • Visalia, CA
National Provider Identifier
1114099389
Registry record updated Mar 7, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
OT 1600 Issued in CA
Practice address
1827 S Court St
Suite C
Visalia, CA 93277-5469
Phone
(559) 627-3274
Fax
(559) 627-3284
NPI assigned
Nov 14, 2006
Last updated
Mar 7, 2008By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X OT 1600 CA Primary

Addresses

Primary practice location

1827 S Court St
Suite C
Visalia, CA 93277-5469

Mailing address

2515 E Princeton Ave
Visalia, CA 93292-5678
Phone (559) 280-5661

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070711000821 CA Practitioner - Occupational Therapist in Private Practice 4688773906 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 1977
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Dash Therapy a Professional CorporationGroup PAC ID 3577733328, 3 clinicians

Practice addresses (Care Compare)

2208 W Sunnyside Ave
Suite a
Visalia, CA 93277-7292
Phone (559) 627-3274

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OT 1600CAMDSpecialist

Practice roles

OrganizationSpecialtyStatusNew patients
Dash Therapy a Professional Corporation CurrentSince Jul 8, 2011 Accepting new patients

Locations

511 W Visalia Rd
Exeter, CA 93221
Phone (559) 592-7117

3362 S Fairway St
Visalia, CA 93277
Phone (559) 625-2476

2208 W Sunnyside Ave
Ste A
Visalia, CA 93277
Phone (559) 627-3274

1827 S Court St
Ste C
Visalia, CA 93277
Phone (559) 627-3274

Organizations & group practices 1

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": "1163462400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1204848000000",
    "number": "1114099389",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2515 E PRINCETON AVE",
            "city": "VISALIA",
            "state": "CA",
            "postal_code": "932925678",
            "telephone_number": "559-280-5661",
            "fax_number": "559-625-0389"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1827 S COURT ST",
            "address_2": "SUITE C",
            "city": "VISALIA",
            "state": "CA",
            "postal_code": "932775469",
            "telephone_number": "559-627-3274",
            "fax_number": "559-627-3284"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JEWELL",
        "first_name": "MARY",
        "middle_name": "COLETTE",
        "name_prefix": "Ms.",
        "credential": "OT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-14",
        "last_updated": "2008-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "CA",
            "license": "OT 1600",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Visalia, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.