Individual provider Active NPI

Jacqueline Michel, OTR/L

  • Occupational Therapist
  • Philadelphia, PA
National Provider Identifier
1235538109
Registry record updated Aug 17, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
TOC102942 Issued in PA
Practice address
2990 Holme Ave
Philadelphia, PA 19136-1830
Phone
(215) 335-2100
NPI assigned
Aug 17, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 17, 2014

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 TOC102942 PA Primary

Addresses

Primary practice location

2990 Holme Ave
Philadelphia, PA 19136-1830

Mailing address

1511 Long Pond Dr
Warrington, PA 18976-1328
Phone (215) 530-5411

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
TOC102942PAMDOccupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1408233600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1408233600000",
    "number": "1235538109",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1511 LONG POND DR",
            "city": "WARRINGTON",
            "state": "PA",
            "postal_code": "189761328",
            "telephone_number": "215-530-5411"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2990 HOLME AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191361830",
            "telephone_number": "215-335-2100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MICHEL",
        "first_name": "JACQUELINE",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-08-17",
        "last_updated": "2014-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "PA",
            "license": "TOC102942",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2014; 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.