Beth Jordan, OTD, MSOTR

Primary specialty

Pediatric Occupational TherapistTaxonomy code 225XP0200X

License

015186 Issued in NY

Practice address

219 County Route 57
Unit 20
Phoenix, NY 13135-3300

Phone

(315) 934-4459

Fax

(315) 934-4459

NPI assigned

Dec 16, 2008

Last updated

Mar 29, 2013By the provider in NPPES

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 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• On the Move Occupational Therapy, PLLC

  • Pediatric Occupational Therapist
  • Phoenix, NY
  • NPI 1659668986

  Pediatrics

  NPD (past) Authorized official

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

{
    "created_epoch": "1229385600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1364515200000",
    "number": "1407091713",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "219 COUNTY ROUTE 57",
            "address_2": "UNIT 20",
            "city": "PHOENIX",
            "state": "NY",
            "postal_code": "131353300",
            "telephone_number": "315-934-4459",
            "fax_number": "315-934-4459"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "219 COUNTY ROUTE 57",
            "address_2": "UNIT 20",
            "city": "PHOENIX",
            "state": "NY",
            "postal_code": "131353300",
            "telephone_number": "315-934-4459",
            "fax_number": "315-934-4459"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JORDAN",
        "first_name": "BETH",
        "credential": "OTD, MSOTR",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-12-16",
        "last_updated": "2013-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "NY",
            "license": "015186",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03426868",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Caitlin Marie George
• Charlene Elizabeth Gill, RN
• Nicole Gilona, MS, OTR/L
• Peter D Gray, D.M.D.
• Amy Ilardi, REGISTERED NURSE
• Paul G Lakomski, R.PH.
• Paul J Masuicca, DDS
• Ann Marie Milewski, CCC, NYS LIC.
• Erin Judith Moore, LPN
• Anne-Marie Elizabeth Muller, LCSW

• Pediatric Occupational Therapist in Phoenix, NY
• Providers in Phoenix, NY by specialty
• Pediatric Occupational Therapist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2013; 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.