Jacqueline Green

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

0119005764 Issued in VA

Practice address

4019 18TH St S
Arlington, VA 22204-5141

Phone

(703) 967-9981

NPI assigned

Dec 20, 2016

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

Medicare fee-for-service enrollment

Enrolled in VA, DC2 enrollments

Enrollment records 2

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Bal Therapy LLC

  • Physical Therapist
  • Arlington, VA
  • NPI 1003426297

  DC, Occupational Therapist

  Medicare reassignment NPD
• Comprehensive Therapeutics LTD

  • Physical Therapist
  • North Riverside, IL
  • NPI 1699094102

  Occupational Therapist, VA

  Medicare reassignment NPD
• Comprehensive Therapeutics LTD

  • Physical Therapist
  • Lagrange, GA
  • NPI 1881458354

  Occupational Therapist

  NPD

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

{
    "created_epoch": "1482192000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716249600000",
    "number": "1386189728",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4703 W BRADDOCK RD APT 30",
            "city": "ALEXANDRIA",
            "state": "VA",
            "postal_code": "223114706",
            "telephone_number": "814-233-1450"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4019 18TH ST S",
            "city": "ARLINGTON",
            "state": "VA",
            "postal_code": "222045141",
            "telephone_number": "703-967-9981"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4703 W Braddock Rd Apt 30",
            "address_purpose": "LOCATION",
            "city": "Alexandria",
            "state": "VA",
            "postal_code": "223114706",
            "country_code": "US",
            "telephone_number": "814-233-1450",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GREEN",
        "first_name": "JACQUELINE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-12-20",
        "last_updated": "2024-05-21",
        "certification_date": "2024-05-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "VA",
            "license": "0119005764",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lewis Winston Graves Jr., PT, DPT
• Kayla McKenzie Gray-Hillian, SPT
• Ana-Maria Gray, MD
• Danine Fresch Gray, DDS
• Great Smile Dental
• Laurel Marion Green
• Rachel Greenberg, CRNA
• Greenbrook TMS, Arlington, LLC
• Alexis Charmaine Greene
• Raven Greene

• Occupational Therapist in Arlington, VA
• Providers in Arlington, VA by specialty
• Occupational Therapist in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.