Individual provider Active NPI

Joyce Jacobs, M.S.,O.T.R.

  • Occupational Therapist
  • New Palestine, IN
National Provider Identifier
1366567612
Registry record updated Jun 10, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
31000104A Issued in IN
Practice address
7899 Bristol Way
New Palestine, IN 46163-8786
Phone
(317) 440-3690
Fax
(317) 861-9329
NPI assigned
Mar 19, 2007
Last updated
Jun 10, 2008By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 10, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 31000104A IN Primary

Addresses

Primary practice location

7899 Bristol Way
New Palestine, IN 46163-8786

Mailing address

7899 Bristol Way
New Palestine, IN 46163-8786
Phone (317) 440-3690

Other identifiers 1

IdentifierTypeStateIssuer
200612430MedicaidIN

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
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
31000104AINMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Therapeds LLC Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1174262400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1213056000000",
    "number": "1366567612",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7899 BRISTOL WAY",
            "city": "NEW PALESTINE",
            "state": "IN",
            "postal_code": "461638786",
            "telephone_number": "317-440-3690",
            "fax_number": "317-861-9329"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7899 BRISTOL WAY",
            "city": "NEW PALESTINE",
            "state": "IN",
            "postal_code": "461638786",
            "telephone_number": "317-440-3690",
            "fax_number": "317-861-9329"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACOBS",
        "first_name": "JOYCE",
        "name_prefix": "Mrs.",
        "credential": "M.S.,O.T.R.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-19",
        "last_updated": "2008-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "IN",
            "license": "31000104A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200612430",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New Palestine, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2008; 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.