Active NPI
Stephanie A Jackson, OTR/L
- Occupational Therapist
- Front Royal, VA
National Provider Identifier
1144798950
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 0119007678
- Practice address
- 151 Skyline Vista Dr
Front Royal, VA 22630-8219 - Phone
- (540) 631-0366
- NPI assigned
- Nov 9, 2018
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 0119007678 | VA | Primary |
Addresses
Primary practice location
151 Skyline Vista Dr
Front Royal, VA 22630-8219
Mailing address
1000 Opequon Ave
Winchester, VA 22601-5130
Phone (540) 664-7622
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 |
|---|---|---|---|
| 0119007678 | VA | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1541721600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1541721600000",
"number": "1144798950",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1000 OPEQUON AVE",
"city": "WINCHESTER",
"state": "VA",
"postal_code": "226015130",
"telephone_number": "540-664-7622"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "151 SKYLINE VISTA DR",
"city": "FRONT ROYAL",
"state": "VA",
"postal_code": "226308219",
"telephone_number": "540-631-0366"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JACKSON",
"first_name": "STEPHANIE",
"middle_name": "A",
"credential": "OTR/L",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-11-09",
"last_updated": "2018-11-09",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "VA",
"license": "0119007678",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Front Royal, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.