Jessica Lynn Erbis, OTRL

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

002758 Issued in CT

Practice address

132 Elm St
Cheshire, CT 06410-2808

Phone

(203) 250-9663

Fax

(203) 699-9641

NPI assigned

May 17, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 7

Other names 1

• Mrs. Jessica Lynn Beaudoin Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

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.

• Cheshire Fitness Zone, LLC

  • Pediatric Physical Therapist
  • Cheshire, CT
  • NPI 1205961547
  NPD (past)

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

{
    "created_epoch": "1179360000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1324512000000",
    "number": "1376750554",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "132 ELM ST",
            "city": "CHESHIRE",
            "state": "CT",
            "postal_code": "064102808",
            "telephone_number": "203-250-9663",
            "fax_number": "203-699-9641"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "132 ELM ST",
            "city": "CHESHIRE",
            "state": "CT",
            "postal_code": "064102808",
            "telephone_number": "203-250-9663",
            "fax_number": "203-699-9641"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ERBIS",
        "first_name": "JESSICA",
        "middle_name": "LYNN",
        "name_prefix": "Mrs.",
        "credential": "OTRL",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-17",
        "last_updated": "2011-12-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "CT",
            "license": "002758",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "130002758CT01",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA ORTHONET",
            "identifier": "0100901",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CONNECTICARE",
            "identifier": "754954",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "64-04292",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "9044356",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "3672389002",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA ORTHONET",
            "identifier": "0012701",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JESSICA",
            "last_name": "BEAUDOIN",
            "middle_name": "LYNN",
            "prefix": "MRS.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Erica Elliott, OT
• Jason Emery, PSY.D.
• Ophelia Sison Empleo-Frazier, MSN, GNP-BC
• Kelsey Eng, PHYSICAL THERAPIST
• Victoria Anne Hodge Enquist, LCSW
• Marty L Ernstoff, LMFT
• Larry Erwich, DMD
• Antonio R Esposito, RPT
• Lisa Esposito
• Samantha Estelle-Abate, MSN, APRN, FNP-BC

• Occupational Therapist in Cheshire, CT
• Providers in Cheshire, CT by specialty
• Occupational Therapist in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 22, 2011; 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.