Individual provider Active NPI

Janie Jo Hickfang

  • Occupational Therapy Assistant
  • Columbus, OH
National Provider Identifier
1407481088
Registry record updated Mar 4, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Therapy AssistantTaxonomy code 224Z00000X
License
OTA000321 Issued in OH
Practice address
4625 Knightsbridge Blvd
Columbus, OH 43214-4338
Phone
(614) 453-9866
Fax
(614) 326-0079
NPI assigned
Mar 4, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 4, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy Assistant 224Z00000X OTA000321 OH Primary

Addresses

Primary practice location

4625 Knightsbridge Blvd
Columbus, OH 43214-4338

Mailing address

4625 Knightsbridge Blvd
Columbus, OH 43214-4338
Phone (614) 453-9866

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
OTA000321OHMDOccupational Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Spectrum Psychological Services, Inc PastSince Mar 9, 2020 Accepting new patients

Organizations & group practices 1

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": "1583280000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1583280000000",
    "number": "1407481088",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4625 KNIGHTSBRIDGE BLVD",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432144338",
            "telephone_number": "614-453-9866",
            "fax_number": "614-326-0079"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4625 KNIGHTSBRIDGE BLVD",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432144338",
            "telephone_number": "614-453-9866",
            "fax_number": "614-326-0079"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HICKFANG",
        "first_name": "JANIE",
        "middle_name": "JO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-03-04",
        "last_updated": "2020-03-04",
        "certification_date": "2020-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "OH",
            "license": "OTA000321",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbus, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2020; 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.