Active NPI
Eureka Lapearle Jackson, OTR
- Occupational Therapist
- Walkersville, MD
National Provider Identifier
1225478779
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 06379
- Practice address
- 56 W Frederick St
Walkersville, MD 21793-8254 - Phone
- (301) 898-4300
- NPI assigned
- Jun 28, 2013
- Sex
- Female
- Sole proprietor
- Yes
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 | 06379 | MD | Primary |
Addresses
Primary practice location
56 W Frederick St
Walkersville, MD 21793-8254
Mailing address
56 W Frederick St
Walkersville, MD 21793-8254
Phone (301) 898-4300
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1372377600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1372377600000",
"number": "1225478779",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "56 W FREDERICK ST",
"city": "WALKERSVILLE",
"state": "MD",
"postal_code": "217938254",
"telephone_number": "301-898-4300"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "56 W FREDERICK ST",
"city": "WALKERSVILLE",
"state": "MD",
"postal_code": "217938254",
"telephone_number": "301-898-4300"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JACKSON",
"first_name": "EUREKA",
"middle_name": "LAPEARLE",
"name_prefix": "Mr.",
"credential": "OTR",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2013-06-28",
"last_updated": "2013-06-28",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "MD",
"license": "06379",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Walkersville, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 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.