Jeannie L Poole, O.T.

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

Practice address

852 Commerce Ave
Longview, WA 98632-2406

Phone

(360) 501-3750

NPI assigned

May 23, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in ID

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• MHD Therapies, PLLC

  • Physical Therapist
  • Rexburg, ID
  • NPI 1316484983

  Occupational Therapist

  Medicare reassignment NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1179878400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1194998400000",
    "number": "1144430398",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3002",
            "city": "LONGVIEW",
            "state": "WA",
            "postal_code": "986320302",
            "telephone_number": "360-414-2048",
            "fax_number": "360-575-6749"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "852 COMMERCE AVE",
            "city": "LONGVIEW",
            "state": "WA",
            "postal_code": "986322406",
            "telephone_number": "360-501-3750"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POOLE",
        "first_name": "JEANNIE",
        "middle_name": "L",
        "name_prefix": "Mrs.",
        "credential": "O.T.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-23",
        "last_updated": "2007-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CRIME VICTIMS",
            "identifier": "8944617",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LABOR & IND",
            "identifier": "0221530",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8483760",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ryan Poland, R-AAC, CPC
• Jonathan A. Polikoff, MD
• Stephanie Pollard
• Tina M Pond, RN
• Alysha Marie Poole
• Jolivia Porter, M.A.
• Gretchen Marie Potschka, MD
• Alexander Potter, MA, LMHC, SUDP
• John Robert Potter, CDPT
• Jennifer Irene Potterton, MSW LICSW

• Occupational Therapist in Longview, WA
• Providers in Longview, WA by specialty
• Occupational Therapist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.