Jackie Abele, COTA/L

Key facts

NPI

1407097355

Entity type

Individual (NPI type 1)

Primary specialty

Occupational Therapy Assistant 224Z00000X

License

OTA. 03330 (OH)

Practice address

7235 Whipple Ave NW
North Canton, OH 44720-7137

Phone

(330) 498-8200

NPI assigned

Mar 23, 2009

Sex

Female

Sole proprietor

No

Medicare participation

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)

No

State licenses

Specialties & licenses

Addresses

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Mar 23, 2009.

{
    "created_epoch": "1237766400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1237766400000",
    "number": "1407097355",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1395 PINEY CREEK RD",
            "city": "CHILLICOTHE",
            "state": "OH",
            "postal_code": "456018930"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7235 WHIPPLE AVE NW",
            "city": "NORTH CANTON",
            "state": "OH",
            "postal_code": "447207137",
            "telephone_number": "330-498-8200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ABELE",
        "first_name": "JACKIE",
        "credential": "COTA/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-03-23",
        "last_updated": "2009-03-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "OH",
            "license": "OTA. 03330",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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