Individual provider Active NPI

Jayme Michelle Mancera, OTR

  • Occupational Therapist
  • Columbus, GA
National Provider Identifier
1205264306
Registry record updated Oct 29, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
OT005678 Issued in GA
Practice address
2515 Double Churches Rd
Columbus, GA 31909-2742
Phone
(706) 660-5495
Fax
(706) 660-5497
NPI assigned
Oct 29, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 29, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X OT005678 GA Primary

Addresses

Primary practice location

2515 Double Churches Rd
Columbus, GA 31909-2742

Mailing address

8461 Chaffee St
Fort Benning, GA 31905-7045
Phone (915) 202-3114

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
OT005678GAMDOccupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1383004800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1383004800000",
    "number": "1205264306",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8461 CHAFFEE ST",
            "city": "FORT BENNING",
            "state": "GA",
            "postal_code": "319057045",
            "telephone_number": "915-202-3114"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2515 DOUBLE CHURCHES RD",
            "city": "COLUMBUS",
            "state": "GA",
            "postal_code": "319092742",
            "telephone_number": "706-660-5495",
            "fax_number": "706-660-5497"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANCERA",
        "first_name": "JAYME",
        "middle_name": "MICHELLE",
        "name_prefix": "Mrs.",
        "credential": "OTR",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-10-29",
        "last_updated": "2013-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "GA",
            "license": "OT005678",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbus, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2013; 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.