Individual provider Active NPI

Jessica Hall, COTA

  • Occupational Therapy Assistant
  • Fort Oglethorpe, GA
National Provider Identifier
1174057590
Registry record updated Apr 12, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Therapy AssistantTaxonomy code 224Z00000X
License
OTA001535 Issued in GA
Practice address
2403 Battlefield Pkwy
Fort Oglethorpe, GA 30742-4033
Phone
(706) 866-7700
NPI assigned
Apr 12, 2017
Last updated
Apr 12, 2017By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 12, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy Assistant 224Z00000X 2214 TN
Occupational Therapy Assistant 224Z00000X OTA001535 GA Primary

Addresses

Primary practice location

2403 Battlefield Pkwy
Fort Oglethorpe, GA 30742-4033

Mailing address

2403 Battlefield Pkwy
Fort Oglethorpe, GA 30742-4033
Phone (706) 866-7700

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

LicenseStateTypeSpecialty
2214TNMDMarriage & Family Therapist
OTA001535GAMDOccupational Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1491955200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1491955200000",
    "number": "1174057590",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2403 BATTLEFIELD PKWY",
            "city": "FORT OGLETHORPE",
            "state": "GA",
            "postal_code": "307424033",
            "telephone_number": "706-866-7700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2403 BATTLEFIELD PKWY",
            "city": "FORT OGLETHORPE",
            "state": "GA",
            "postal_code": "307424033",
            "telephone_number": "706-866-7700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HALL",
        "first_name": "JESSICA",
        "name_prefix": "Mrs.",
        "credential": "COTA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-04-12",
        "last_updated": "2017-04-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "TN",
            "license": "2214",
            "primary": false
        },
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "GA",
            "license": "OTA001535",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Oglethorpe, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 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.

Verify at the official NPI Registry.