Active NPI
Keri Jacobs
- Occupational Therapy Assistant
- Wallingford, CT
National Provider Identifier
1447800297
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapy Assistant
- License
- 1852
- Practice address
- 101 Summerhill Rd
Wallingford, CT 06492-3476 - Phone
- (203) 215-4156
- NPI assigned
- Sep 13, 2019
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapy Assistant | 224Z00000X | 1852 | CT | Primary |
Addresses
Primary practice location
101 Summerhill Rd
Wallingford, CT 06492-3476
Mailing address
101 Summerhill Rd
Wallingford, CT 06492-3476
Phone (203) 215-4156
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1568332800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1568332800000",
"number": "1447800297",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "101 SUMMERHILL RD",
"city": "WALLINGFORD",
"state": "CT",
"postal_code": "064923476",
"telephone_number": "203-215-4156"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "101 SUMMERHILL RD",
"city": "WALLINGFORD",
"state": "CT",
"postal_code": "064923476",
"telephone_number": "203-215-4156"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JACOBS",
"first_name": "KERI",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2019-09-13",
"last_updated": "2019-09-13",
"status": "A"
},
"taxonomies": [
{
"code": "224Z00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Occupational Therapy Assistant",
"state": "CT",
"license": "1852",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Wallingford, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 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.