Individual provider Active NPI

Jessica Leigh Alvarez, OTA/L

  • Occupational Therapy Assistant
  • Gainesville, GA
National Provider Identifier
1376815050
Registry record updated Aug 8, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Therapy AssistantTaxonomy code 224Z00000X
License
001170 Issued in GA
Practice address
2435 Limestone Pkwy
Gainesville, GA 30501-2093
Phone
(678) 940-1101
NPI assigned
Jan 27, 2012
Last updated
Aug 8, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 8, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy Assistant 224Z00000X 001170 GA Primary

Addresses

Primary practice location

2435 Limestone Pkwy
Gainesville, GA 30501-2093

Mailing address

1697 Thompson Bridge Rd
Gainesville, GA 30501-1715

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

LicenseStateTypeSpecialty
001170GAMDSurgical Physician Assistant

NPI Registry JSON

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

{
    "created_epoch": "1327622400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691452800000",
    "number": "1376815050",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1697 THOMPSON BRIDGE RD",
            "city": "GAINESVILLE",
            "state": "GA",
            "postal_code": "305011715"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2435 LIMESTONE PKWY",
            "city": "GAINESVILLE",
            "state": "GA",
            "postal_code": "305012093",
            "telephone_number": "678-940-1101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALVAREZ",
        "first_name": "JESSICA",
        "middle_name": "LEIGH",
        "name_prefix": "Miss",
        "credential": "OTA/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-01-27",
        "last_updated": "2023-08-08",
        "certification_date": "2023-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "GA",
            "license": "001170",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gainesville, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2023; 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.