Active NPI
James Matthew Jordan, OCCUPATIONAL THERAPI
- Occupational Therapist
- St Louis, MO
National Provider Identifier
1285753772
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- OTR1668
- Practice address
- 32 Hampton Village Plaza
St Louis, MO 63109 - Phone
- (314) 353-2626
- NPI assigned
- Mar 28, 2007
- Reactivated
- Aug 7, 2008
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | OTR1668 | AR | Primary |
Addresses
Primary practice location
32 Hampton Village Plaza
St Louis, MO 63109
Mailing address
32 Hampton Village Plaza
St Louis, MO 63109
Phone (314) 353-2626
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 |
|---|---|---|---|
| OTR1668 | AR | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1175040000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1218067200000",
"number": "1285753772",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "32 HAMPTON VILLAGE PLAZA",
"city": "ST LOUIS",
"state": "MO",
"postal_code": "63109",
"telephone_number": "314-353-2626"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "32 HAMPTON VILLAGE PLAZA",
"city": "ST LOUIS",
"state": "MO",
"postal_code": "63109",
"telephone_number": "314-353-2626"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JORDAN",
"first_name": "JAMES",
"middle_name": "MATTHEW",
"name_prefix": "Mr.",
"credential": "OCCUPATIONAL THERAPI",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-03-28",
"last_updated": "2008-08-07",
"deactivation_date": "2008-07-10",
"reactivation_date": "2008-08-07",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "AR",
"license": "OTR1668",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in St Louis, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.