Active NPI
Jamie Spidle McKenzie, OTR/L
- Occupational Therapist
- Daphne, AL
National Provider Identifier
1285877563
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 249399
- 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
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 | 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 ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| 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
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
| License | State | Type | Specialty |
|---|---|---|---|
| 249399 | AL | MD | Occupational Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| BTR Business, LLC | Occupational Therapist | Current | Accepting new patients |
| Eastern Shore Physical Therapy, Inc | Past | 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.
-
- Physical Therapy Clinic/Center
- Daphne, AL
- NPI 1700831666
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.