Individual provider Active NPI

Jackelyn Elizabeth Rockwood

  • Occupational Therapist
  • Durham, NC
National Provider Identifier
1386154060
Registry record updated Sep 26, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
11385 Issued in NC
Practice address
3905 University Dr
Durham, NC 27707-2517
Phone
(919) 928-0204
NPI assigned
Oct 6, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 26, 2019

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 11385 NC Primary

Addresses

Primary practice location

3905 University Dr
Durham, NC 27707-2517

Mailing address

153 Red Admiral CT
Hillsborough, NC 27278-8124

Other practice location 1

1829 E Franklin St Ste 600
Chapel Hill, NC 27514-5863
Phone (919) 968-3456

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
11385NCMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Emerge-a Child'S Place, PLLC Occupational Therapist CurrentSince Feb 23, 2020 Accepting new patients
Total Rehabilitation Inc Occupational Therapist Past Accepting new patients

Locations

3905 University Dr
Durham, NC 27707
Phone (919) 246-0590

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1507248000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1569456000000",
    "number": "1386154060",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "153 RED ADMIRAL CT",
            "city": "HILLSBOROUGH",
            "state": "NC",
            "postal_code": "272788124"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3905 UNIVERSITY DR",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277072517",
            "telephone_number": "919-928-0204"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1829 E Franklin St Ste 600",
            "address_purpose": "LOCATION",
            "city": "Chapel Hill",
            "state": "NC",
            "postal_code": "275145863",
            "country_code": "US",
            "telephone_number": "919-968-3456",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROCKWOOD",
        "first_name": "JACKELYN",
        "middle_name": "ELIZABETH",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-10-06",
        "last_updated": "2019-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NC",
            "license": "11385",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Durham, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2019; 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.