Individual provider Active NPI

Jahi Gains, OTR/L

  • Occupational Therapist
  • Glendale, AZ
National Provider Identifier
1205500139
Registry record updated Aug 4, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
008564 Issued in AZ
Practice address
4650 W Sweetwater Ave
Glendale, AZ 85304-1505
Phone
(602) 347-2865
NPI assigned
Aug 4, 2021
Last updated
Aug 4, 2021By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 4, 2021

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 008564 AZ Primary

Addresses

Primary practice location

4650 W Sweetwater Ave
Glendale, AZ 85304-1505

Mailing address

4650 W Sweetwater Ave
Glendale, AZ 85304-1505

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230223000481 AZ Practitioner - Occupational Therapist in Private Practice 8426421306 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
008564AZMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Solace Pediatric Healthcare Therapy Services Az, Inc. Occupational Therapist CurrentSince Nov 19, 2022 Accepting new patients
Pioneer Pet, LLC Past Accepting new patients

Locations

1930 E Southern Ave
Tempe, AZ 85282
Phone (480) 456-0719

60 E Rio Salado Pkwy
Ste 900
Tempe, AZ 85281
Phone (480) 456-0719

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1628035200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1628035200000",
    "number": "1205500139",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4650 W SWEETWATER AVE",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853041505"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4650 W SWEETWATER AVE",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853041505",
            "telephone_number": "602-347-2865"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAINS",
        "first_name": "JAHI",
        "credential": "OTR/L",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-08-04",
        "last_updated": "2021-08-04",
        "certification_date": "2021-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "AZ",
            "license": "008564",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glendale, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.