Active NPI
Jessica Porter Cook
- Occupational Therapist
- Rexburg, ID
National Provider Identifier
1194173344
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- OTL- 1609
- Practice address
- 393 E 2ND N
Rexburg, ID 83440-1605 - Phone
- (208) 359-9570
- NPI assigned
- May 28, 2016
- 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 | OTL- 1609 | ID | Primary |
Addresses
Primary practice location
393 E 2ND N
Rexburg, ID 83440-1605
Mailing address
175 Stockham Blvd Apt 2
Rigby, ID 83442-1283
Other names 1
- Jessica Porter
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 |
|---|---|---|---|
| OTL- 1609 | ID | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1464393600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1508889600000",
"number": "1194173344",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "175 STOCKHAM BLVD APT 2",
"city": "RIGBY",
"state": "ID",
"postal_code": "834421283"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "393 E 2ND N",
"city": "REXBURG",
"state": "ID",
"postal_code": "834401605",
"telephone_number": "208-359-9570"
}
],
"practiceLocations": [],
"basic": {
"last_name": "COOK",
"first_name": "JESSICA",
"middle_name": "PORTER",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-05-28",
"last_updated": "2017-10-25",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "ID",
"license": "OTL- 1609",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "JESSICA",
"last_name": "PORTER",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Rexburg, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 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.