Active NPI
Marielise Jacobs, OTR/L
- Pediatric Occupational Therapist
- Melbourne, FL
National Provider Identifier
1245644111
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Occupational Therapist
- License
- OT16287
- Practice address
- 1751 Sarno Rd Ste 5
Melbourne, FL 32935-4909 - Phone
- (321) 255-7779
- Fax
- (321) 255-7774
- NPI assigned
- Jun 18, 2014
- 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 |
|---|---|---|---|---|
| Pediatric Occupational Therapist | 225XP0200X | OT16287 | FL | Primary |
Addresses
Primary practice location
1751 Sarno Rd Ste 5
Melbourne, FL 32935-4909
Mailing address
1751 Sarno Rd Ste 5
Melbourne, FL 32935-4909
Phone (321) 255-7779
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
| License | State | Type | Specialty |
|---|---|---|---|
| OT16287 | FL | MD | Pediatric Occupational Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| 7 Senses Therapy, LLC | Pediatrics | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1403049600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1403049600000",
"number": "1245644111",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1751 SARNO RD STE 5",
"city": "MELBOURNE",
"state": "FL",
"postal_code": "329354909",
"telephone_number": "321-255-7779",
"fax_number": "321-255-7774"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1751 SARNO RD STE 5",
"city": "MELBOURNE",
"state": "FL",
"postal_code": "329354909",
"telephone_number": "321-255-7779",
"fax_number": "321-255-7774"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JACOBS",
"first_name": "MARIELISE",
"credential": "OTR/L",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-06-18",
"last_updated": "2014-06-18",
"status": "A"
},
"taxonomies": [
{
"code": "225XP0200X",
"taxonomy_group": "",
"desc": "Occupational Therapist, Pediatrics",
"state": "FL",
"license": "OT16287",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Melbourne, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 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.