NPIMap

Organization Active NPI

Prosperous Living LLC

  • Occupational Therapist
  • Pelham, AL
National Provider Identifier
1336548783
Registry record updated Aug 21, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
2276 Issued in AL
Legal business name
PROSPEROUS LIVING LLC
Practice address
1974 Chandalar Dr
Suite D
Pelham, AL 35124-4340
Phone
(205) 358-3515
NPI assigned
Aug 21, 2014
Last updated
Aug 21, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 21, 2014

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

Authorized official

Name
Stacie Jackson, OTR/LNPI 1225202393
Title
Occupational Therapist/President
Phone
(205) 266-5394

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 2276 AL Primary
Gerontology Occupational Therapist 225XG0600X 2276 AL
Low Vision Occupational Therapist 225XL0004X 2276 AL

Addresses

Primary practice location

1974 Chandalar Dr
Suite D
Pelham, AL 35124-4340

Mailing address

719 Heritage Park LN
Hoover, AL 35226-4198
Phone (205) 266-5394

Other identifiers 1

IdentifierTypeStateIssuer
2276OtherALOCCUPATIONAL THERAPIST

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1408579200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1408579200000",
    "number": "1336548783",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "719 HERITAGE PARK LN",
            "city": "HOOVER",
            "state": "AL",
            "postal_code": "352264198",
            "telephone_number": "205-266-5394",
            "fax_number": "205-358-3517"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1974 CHANDALAR DR",
            "address_2": "SUITE D",
            "city": "PELHAM",
            "state": "AL",
            "postal_code": "351244340",
            "telephone_number": "205-358-3515"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROSPEROUS LIVING LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-08-21",
        "last_updated": "2014-08-21",
        "status": "A",
        "authorized_official_last_name": "JACKSON",
        "authorized_official_first_name": "STACIE",
        "authorized_official_title_or_position": "OCCUPATIONAL THERAPIST/PRESIDENT",
        "authorized_official_telephone_number": "205-266-5394",
        "authorized_official_credential": "OTR/L"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "AL",
            "license": "2276",
            "primary": true
        },
        {
            "code": "225XG0600X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Gerontology",
            "state": "AL",
            "license": "2276",
            "primary": false
        },
        {
            "code": "225XL0004X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Low Vision",
            "state": "AL",
            "license": "2276",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OCCUPATIONAL THERAPIST",
            "identifier": "2276",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pelham, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2014; 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.