Active NPI
Jessica Um
- Occupational Therapist
- Winston-Salem, NC
National Provider Identifier
1285138123
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- Practice address
- 601 Martin Luther King Jr Dr
432 FL Atkins Building
Winston-Salem, NC 27110-0001 - Phone
- (336) 750-3174
- NPI assigned
- Mar 23, 2018
- 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 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Technician | 106S00000X | RBT-18-51065 | NC | |
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Occupational Therapist | 225X00000X | Primary |
Addresses
Primary practice location
601 Martin Luther King Jr Dr
432 FL Atkins Building
Winston-Salem, NC 27110-0001
Mailing address
601 Martin Luther King Jr Dr
432 FL Atkins BLDG
Winston-Salem, NC 27110-0001
Phone (336) 750-3174
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 |
|---|---|---|---|
| RBT-18-51065 | NC | MD | Behavior Technician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1521763200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1599523200000",
"number": "1285138123",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "601 MARTIN LUTHER KING JR DR",
"address_2": "432 FL ATKINS BLDG",
"city": "WINSTON-SALEM",
"state": "NC",
"postal_code": "271100001",
"telephone_number": "336-750-3174"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "601 MARTIN LUTHER KING JR DR",
"address_2": "432 FL ATKINS BUILDING",
"city": "WINSTON-SALEM",
"state": "NC",
"postal_code": "271100001",
"telephone_number": "336-750-3174"
}
],
"practiceLocations": [],
"basic": {
"last_name": "UM",
"first_name": "JESSICA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-03-23",
"last_updated": "2020-09-08",
"certification_date": "2020-09-08",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": "NC",
"license": "RBT-18-51065",
"primary": false
},
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Winston-Salem, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 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.