Jessica Sams

Primary specialty

Occupational Therapy AssistantTaxonomy code 224Z00000X

License

057002560 Issued in IL

Practice address

404 Broadway St
Gillespie, IL 62033-1105

Phone

(217) 324-2153

Fax

(217) 324-2770

NPI assigned

Aug 6, 2014

Last updated

Aug 6, 2014By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1407283200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1407283200000",
    "number": "1386053098",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "628 S ILLINOIS AVE",
            "city": "LITCHFIELD",
            "state": "IL",
            "postal_code": "620562716"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "404 BROADWAY ST",
            "city": "GILLESPIE",
            "state": "IL",
            "postal_code": "620331105",
            "telephone_number": "217-324-2153",
            "fax_number": "217-324-2770"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAMS",
        "first_name": "JESSICA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-08-06",
        "last_updated": "2014-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "IL",
            "license": "057002560",
            "primary": true
        },
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "IL",
            "license": "0057002560",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Occupational Therapy Assistant in Gillespie, IL
• Providers in Gillespie, IL by specialty
• Occupational Therapy Assistant in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2014; 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.