Individual provider Active NPI

Jill Lyn Metcalf, COTA/L

  • Occupational Therapy Assistant
  • Romney, WV
National Provider Identifier
1326605791
Registry record updated May 21, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Therapy AssistantTaxonomy code 224Z00000X
License
C1420 Issued in WV
Practice address
260 Sunrise Blvd
Romney, WV 26757-6345
Phone
(304) 822-7527
NPI assigned
May 21, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 21, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy Assistant 224Z00000X C1420 WV Primary

Addresses

Primary practice location

260 Sunrise Blvd
Romney, WV 26757-6345

Mailing address

PO Box 410
Fort Ashby, WV 26719-0410
Phone (240) 625-5176

Other names 1

  • Jill Lyn Weisenmiller Former name

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

LicenseStateTypeSpecialty
C1420WVMDOccupational Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1558396800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1558396800000",
    "number": "1326605791",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 410",
            "city": "FORT ASHBY",
            "state": "WV",
            "postal_code": "267190410",
            "telephone_number": "240-625-5176"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "260 SUNRISE BLVD",
            "city": "ROMNEY",
            "state": "WV",
            "postal_code": "267576345",
            "telephone_number": "304-822-7527"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "METCALF",
        "first_name": "JILL",
        "middle_name": "LYN",
        "credential": "COTA/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-05-21",
        "last_updated": "2019-05-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "WV",
            "license": "C1420",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JILL",
            "last_name": "WEISENMILLER",
            "middle_name": "LYN",
            "credential": "COTA/L",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Romney, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 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.