Active NPI
Jan Johnson-Roe, OT
- Occupational Therapist
- Cockeysville, MD
National Provider Identifier
1356708200
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 103717
- Practice address
- 10600 York Rd
Cockeysville, MD 21030-2351 - Phone
- (972) 795-0008
- NPI assigned
- Jan 23, 2016
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 103717 | TX | Primary |
Addresses
Primary practice location
10600 York Rd
Cockeysville, MD 21030-2351
Mailing address
1250 Rivercrest Dr
Mesquite, TX 75181-1076
Phone (972) 795-0008
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 103717 | TX | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1453507200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1453507200000",
"number": "1356708200",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1250 RIVERCREST DR",
"city": "MESQUITE",
"state": "TX",
"postal_code": "751811076",
"telephone_number": "972-795-0008"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10600 YORK RD",
"city": "COCKEYSVILLE",
"state": "MD",
"postal_code": "210302351",
"telephone_number": "972-795-0008"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JOHNSON-ROE",
"first_name": "JAN",
"credential": "OT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-01-23",
"last_updated": "2016-01-23",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "TX",
"license": "103717",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Cockeysville, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.