Active NPI
Jessica Reynolds, OTR/L
- Occupational Therapist
- Wilmington, NC
National Provider Identifier
1174801807
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 7699
- Practice address
- 1011 Porters Neck Rd
Wilmington, NC 28411-9196 - Phone
- (910) 319-7440
- NPI assigned
- Jul 29, 2011
- 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 | 7699 | NC | Primary |
Addresses
Primary practice location
1011 Porters Neck Rd
Wilmington, NC 28411-9196
Mailing address
7628 Mallow Rd
Wilmington, NC 28411-7315
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 7699 | NC | MD | Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1311897600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1311897600000",
"number": "1174801807",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7628 MALLOW RD",
"city": "WILMINGTON",
"state": "NC",
"postal_code": "284117315"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1011 PORTERS NECK RD",
"city": "WILMINGTON",
"state": "NC",
"postal_code": "284119196",
"telephone_number": "910-319-7440"
}
],
"practiceLocations": [],
"basic": {
"last_name": "REYNOLDS",
"first_name": "JESSICA",
"credential": "OTR/L",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-07-29",
"last_updated": "2011-07-29",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "NC",
"license": "7699",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Wilmington, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.