Lisa Jacques

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

2012035100 Issued in MO

Practice address

16972 Manchester Rd
Wildwood, MO 63040-1200

Phone

(636) 477-5187

NPI assigned

Mar 8, 2013

Last updated

Oct 12, 2022By 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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Jacques Optometry LLC

  dba Rockwood Eyecare

  • Optometrist
  • Wildwood, MO
  • NPI 1386217586
  NPD

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

{
    "created_epoch": "1362700800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1665532800000",
    "number": "1457692915",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16972 MANCHESTER RD",
            "city": "WILDWOOD",
            "state": "MO",
            "postal_code": "630401200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16972 MANCHESTER RD",
            "city": "WILDWOOD",
            "state": "MO",
            "postal_code": "630401200",
            "telephone_number": "636-477-5187"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1034 S Brentwood Blvd",
            "address_2": "Suite 300",
            "address_purpose": "LOCATION",
            "city": "Richmond Heights",
            "state": "MO",
            "postal_code": "631171223",
            "country_code": "US",
            "telephone_number": "314-644-1978",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JACQUES",
        "first_name": "LISA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-03-08",
        "last_updated": "2022-10-12",
        "certification_date": "2022-10-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "MO",
            "license": "2012035100",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Susan Lynn Inserra, OTR/L
• Rena A Isenogle, RPH
• Brenda Gail Izen, M.D.
• Eve Jacobs, CNM
• Jacques Optometry LLC (Rockwood Eyecare)
• Peter Damien Jacques, OD
• Julie Ann James, PT, FDNP
• Kiersten Jamison
• Mari E. Janko, PA
• Alexandra Johler, DC MS

• Occupational Therapist in Wildwood, MO
• Providers in Wildwood, MO by specialty
• Occupational Therapist in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 2022; 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.