Jordan Taylor, COTA

Primary specialty

Occupational Therapy AssistantTaxonomy code 224Z00000X

License

2512 Issued in ID

Practice address

1410 S Broadway Ave
Boise, ID 83706-3706

Phone

(208) 949-3481

NPI assigned

Feb 16, 2022

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Lullaby Waters PLLC

  • Occupational Therapist
  • Boise, ID
  • NPI 1114342755
  NPD

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

{
    "created_epoch": "1644969600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1644969600000",
    "number": "1346995552",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1410 S BROADWAY AVE",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837063706",
            "telephone_number": "208-949-3481"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1410 S BROADWAY AVE",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837063706",
            "telephone_number": "208-949-3481"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAYLOR",
        "first_name": "JORDAN",
        "credential": "COTA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-02-16",
        "last_updated": "2022-02-16",
        "certification_date": "2022-02-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "ID",
            "license": "2512",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dylan Taylor, P-PRC
• Ekaterina Alex Taylor, FNP-C
• Eric Anthony Taylor, ATC
• Everett Anthony Taylor
• Jana Lyn Taylor, LPCP
• Kaitlyn Taylor, B.S.
• Kara Taylor, LSW, CADC
• Kevin Keith Taylor, MS, ATC
• Laura Balben Taylor, CNM
• Lisa K Taylor, MD

• Occupational Therapy Assistant in Boise, ID
• Providers in Boise, ID by specialty
• Occupational Therapy Assistant in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 2022; 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.