Jaclyn Phipps Webber, OCCUPATIONAL THERAPI

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

4394 Issued in SC

Practice address

4015 2ND Ave Ste B
Summerville, SC 29486-7882

Phone

(803) 929-7408

Fax

(888) 711-0441

NPI assigned

Oct 9, 2014

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1412812800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1576195200000",
    "number": "1316341050",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 168",
            "city": "CRYSTAL SPRINGS",
            "state": "MS",
            "postal_code": "390590168",
            "telephone_number": "803-929-7408",
            "fax_number": "850-588-9641"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4015 2ND AVE STE B",
            "city": "SUMMERVILLE",
            "state": "SC",
            "postal_code": "294867882",
            "telephone_number": "803-929-7408",
            "fax_number": "888-711-0441"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "927 Grace Ave",
            "address_purpose": "LOCATION",
            "city": "Panama City",
            "state": "FL",
            "postal_code": "324012521",
            "country_code": "US",
            "telephone_number": "850-769-5371 x210",
            "fax_number": "850-872-9558",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WEBBER",
        "first_name": "JACLYN",
        "middle_name": "PHIPPS",
        "credential": "OCCUPATIONAL THERAPI",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-10-09",
        "last_updated": "2019-12-13",
        "certification_date": "2019-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "FL",
            "license": "OT16627",
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "SC",
            "license": "4394",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "013553100",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Suzann Hutto Weathers, M.D.
• Julie A Weber, MSP CCC-SLP
• Emma Lynn Webster, FNP-C
• Lindsay Weiler, DPT
• Mason Patrick Weisgarber, PA-C
• Erin Welch, PT, DPT

• Occupational Therapist in Summerville, SC
• Providers in Summerville, SC by specialty
• Occupational Therapist in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2019; 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.