Active NPI
Jocelyn Blanks, COTA
- Occupational Therapy Assistant
- Beaumont, TX
National Provider Identifier
1164801379
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapy Assistant
- License
- 212673
- Practice address
- 5555 R Daniel Dr
Apt 141
Beaumont, TX 77705-0624 - Phone
- (561) 351-8075
- NPI assigned
- May 20, 2015
- Last updated
- May 20, 2015
- Sex
- Female
- Sole proprietor
- Yes
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 Therapy Assistant | 224Z00000X | 212673 | TX | Primary |
Addresses
Primary practice location
5555 R Daniel Dr
Apt 141
Beaumont, TX 77705-0624
Mailing address
5555 R Daniel Dr
Apt 141
Beaumont, TX 77705-0624
Phone (561) 351-8075
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 212673 | Other | TX | OCCUPATIONAL THERAPY ASSISTANT LICENSE |
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 |
|---|---|---|---|
| 212673 | TX | MD | Occupational Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1432080000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1432080000000",
"number": "1164801379",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5555 R DANIEL DR",
"address_2": "APT 141",
"city": "BEAUMONT",
"state": "TX",
"postal_code": "777050624",
"telephone_number": "561-351-8075"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5555 R DANIEL DR",
"address_2": "APT 141",
"city": "BEAUMONT",
"state": "TX",
"postal_code": "777050624",
"telephone_number": "561-351-8075"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BLANKS",
"first_name": "JOCELYN",
"credential": "COTA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2015-05-20",
"last_updated": "2015-05-20",
"status": "A"
},
"taxonomies": [
{
"code": "224Z00000X",
"taxonomy_group": "",
"desc": "Occupational Therapy Assistant",
"state": "TX",
"license": "212673",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "OCCUPATIONAL THERAPY ASSISTANT LICENSE",
"identifier": "212673",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}Other providers in Beaumont, TX
- Sherri Blackwell, R. N.
- Maria Susan Blahey, MD
- Darryl Thomas Blalock, MD
- Kimberly Blanchard, LPA
- Martha Balfanz Bland, MS CCC-SLP
- Blessed Homecare of Texas, LLC
- Blessed Homecare of Texas, LLC
- Natalie Blight, NURSE PRACTITIONER
- Blooming Lotus LLC
- Blount Kimball Medical Optometry PA (Texas State Optical Dowlen Road)
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.