Individual provider Active NPI

Jamie Spidle McKenzie, OTR/L

  • Occupational Therapist
  • Daphne, AL
National Provider Identifier
1285877563
Registry record updated Dec 4, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
249399 Issued in AL
Practice address
6475 Van Buren St
Daphne, AL 36526-7585
Phone
(251) 626-9052
NPI assigned
Apr 15, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 4, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 249399 AL Primary

Addresses

Primary practice location

6475 Van Buren St
Daphne, AL 36526-7585

Mailing address

962 Weatherby St South
Saraland, AL 36571-2201
Phone (205) 689-2346

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20091210000176 AL Practitioner - Occupational Therapist in Private Practice 5193865889 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
University of South Alabama College of Medicine, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
BTR Business LLC 2 clinicians

Practice addresses (Care Compare)

5920 Grelot Rd
Suite C2
Mobile, AL 36609-3606
Phone (251) 342-9008

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
249399ALMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
BTR Business, LLC Occupational Therapist CurrentSince Mar 3, 2024 Accepting new patients
Eastern Shore Physical Therapy, Inc PastSince Apr 26, 1996 Accepting new patients

Locations

5920 Grelot Rd
Ste C2
Mobile, AL 36609
Phone (251) 342-9008

Organizations & group practices 2

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": "1239753600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1259884800000",
    "number": "1285877563",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "962 WEATHERBY ST SOUTH",
            "city": "SARALAND",
            "state": "AL",
            "postal_code": "365712201",
            "telephone_number": "205-689-2346"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6475 VAN BUREN ST",
            "city": "DAPHNE",
            "state": "AL",
            "postal_code": "365267585",
            "telephone_number": "251-626-9052"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCKENZIE",
        "first_name": "JAMIE",
        "middle_name": "SPIDLE",
        "name_prefix": "Mrs.",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-04-15",
        "last_updated": "2009-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "AL",
            "license": "249399",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Daphne, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.