Individual provider Active NPI

Jessica Lynn Groff, MOT, OTR/L

  • Occupational Therapist
  • Kahului, HI
National Provider Identifier
1275786279
Registry record updated Jul 27, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
OT-579 Issued in HI
Practice address
472 Kaulana St
Kahului, HI 96732-2050
Phone
(808) 877-7840
NPI assigned
Nov 4, 2008
Last updated
Jul 27, 2015By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 27, 2015

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X OT-579 HI Primary
Occupational Therapist 225X00000X 015255 NY
Occupational Therapist 225X00000X 10536 CA

Addresses

Primary practice location

472 Kaulana St
Kahului, HI 96732-2050

Mailing address

643 Kauhikoa Rd
Haiku, HI 96708-4805
Phone (808) 344-1282

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
10536CAMDOccupational Therapist
OT-579HIMDOccupational Therapist
015255NYMDOccupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1225756800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1437955200000",
    "number": "1275786279",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "643 KAUHIKOA RD",
            "city": "HAIKU",
            "state": "HI",
            "postal_code": "967084805",
            "telephone_number": "808-344-1282"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "472 KAULANA ST",
            "city": "KAHULUI",
            "state": "HI",
            "postal_code": "967322050",
            "telephone_number": "808-877-7840"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GROFF",
        "first_name": "JESSICA",
        "middle_name": "LYNN",
        "credential": "MOT, OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-11-04",
        "last_updated": "2015-07-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "HI",
            "license": "OT-579",
            "primary": true
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NY",
            "license": "015255",
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "CA",
            "license": "10536",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kahului, HI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2015; 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.