Active NPI
Bernadette Ann Jacobs, OT
- Occupational Therapist
- Greenville, SC
National Provider Identifier
1114234945
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 4952
- Practice address
- 29 N Academy St
Greenville, SC 29601-2629 - Phone
- (864) 331-1350
- NPI assigned
- Aug 31, 2010
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | OT004705 | GA | |
| Occupational Therapist | 225X00000X | 4952 | SC | Primary |
Addresses
Primary practice location
29 N Academy St
Greenville, SC 29601-2629
Mailing address
1 Independence PT Ste 212
Greenville, SC 29615-4536
Phone (864) 797-6307
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 |
|---|---|---|---|
| 4952 | SC | MD | Pharmacist |
| OT004705 | GA | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1283212800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1513123200000",
"number": "1114234945",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1 INDEPENDENCE PT STE 212",
"city": "GREENVILLE",
"state": "SC",
"postal_code": "296154536",
"telephone_number": "864-797-6307"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "29 N ACADEMY ST",
"city": "GREENVILLE",
"state": "SC",
"postal_code": "296012629",
"telephone_number": "864-331-1350"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JACOBS",
"first_name": "BERNADETTE",
"middle_name": "ANN",
"credential": "OT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-08-31",
"last_updated": "2017-12-13",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "GA",
"license": "OT004705",
"primary": false
},
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "SC",
"license": "4952",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Greenville, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.