Jessica Lee Daugherty-Peters, OTRL

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

R3595 Issued in KY

Practice address

1043 Brooklyn Blvd
Berea, KY 40403-1090

Phone

(859) 779-8507

NPI assigned

Oct 3, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Theracare Inc

  • Occupational Therapist
  • Manchester, KY
  • NPI 1538253463
  NPD (past)

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

{
    "created_epoch": "1159833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1594771200000",
    "number": "1255425161",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 86",
            "city": "SANDGAP",
            "state": "KY",
            "postal_code": "404810086",
            "telephone_number": "859-779-8507"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1043 BROOKLYN BLVD",
            "city": "BEREA",
            "state": "KY",
            "postal_code": "404031090",
            "telephone_number": "859-779-8507"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAUGHERTY-PETERS",
        "first_name": "JESSICA",
        "middle_name": "LEE",
        "credential": "OTRL",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-03",
        "last_updated": "2020-07-15",
        "certification_date": "2020-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "KY",
            "license": "R3595",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Clint Adam Creekmore, PHARM.D.
• Nora Poynter Croucher, DEVELOPMENTAL INTERV
• Heather Curtsinger
• Dan Sipple Enterprises, LLC
• Tanda Dannelly, MSW
• Larry Edmond Daugherty, DMD
• Terri Susan Daugherty, RN
• Benjamin Phillip Davis
• Gary Ralph Davis, LCSW
• Sandra Hope Davis, LCSW

• Occupational Therapist in Berea, KY
• Providers in Berea, KY by specialty
• Occupational Therapist in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2020; 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.