Active NPI
Jeffrey Jameson
- Occupational Therapist
- Chicago, IL
National Provider Identifier
1346375177
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 056010804
- Practice address
- 811 W Evergreen Ave Ste 404
Chicago, IL 60642-7113 - Phone
- (312) 242-1665
- NPI assigned
- Feb 22, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | OC009084 | PA | |
| Occupational Therapist | 225X00000X | 116050 | TX | |
| Occupational Therapist | 225X00000X | 056010804 | IL | Primary |
Addresses
Primary practice location
811 W Evergreen Ave Ste 404
Chicago, IL 60642-7113
Mailing address
4651 N Greenview Ave Apt 410
Chicago, IL 60640-7944
Phone (312) 860-8846
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1009941340001 | Medicaid | PA |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 056010804 | IL | MD | Occupational Therapist |
| OC009084 | PA | MD | Occupational Therapist |
| 116050 | TX | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1172102400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1489017600000",
"number": "1346375177",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4651 N GREENVIEW AVE APT 410",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606407944",
"telephone_number": "312-860-8846"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "811 W EVERGREEN AVE STE 404",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606427113",
"telephone_number": "312-242-1665"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JAMESON",
"first_name": "JEFFREY",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-02-22",
"last_updated": "2017-03-09",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "PA",
"license": "OC009084",
"primary": false
},
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "TX",
"license": "116050",
"primary": false
},
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "IL",
"license": "056010804",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1009941340001",
"state": "PA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Chicago, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 9, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.