Individual provider Active NPI

Jessica Marie Cerstvik, OTR/L

  • Occupational Therapist
  • Saint Marys, GA
National Provider Identifier
1477501781
Registry record updated Sep 10, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
12201 Issued in FL
Practice address
70 Lindsey LN
Saint Marys, GA 31558
Phone
(912) 510-6104
Fax
(912) 882-6137
NPI assigned
May 5, 2006
Last updated
Sep 10, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 10, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 12201 FL Primary

Addresses

Primary practice location

70 Lindsey LN
Saint Marys, GA 31558

Mailing address

23925 NW 3Rd Ave
Newberry, FL 32669-2246
Phone (352) 490-7500

Other practice location 1

220 N Main St
Suite 2
Chiefland, FL 32626-0869
Phone (352) 490-7500

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
12201FLMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Advance for Kids Inc Occupational Therapist PastSince Mar 11, 2025 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1146787200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1536537600000",
    "number": "1477501781",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23925 NW 3RD AVE",
            "city": "NEWBERRY",
            "state": "FL",
            "postal_code": "326692246",
            "telephone_number": "352-490-7500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "70 LINDSEY LN",
            "city": "SAINT MARYS",
            "state": "GA",
            "postal_code": "31558",
            "telephone_number": "912-510-6104",
            "fax_number": "912-882-6137"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "220 N Main St",
            "address_2": "SUITE 2",
            "address_purpose": "LOCATION",
            "city": "Chiefland",
            "state": "FL",
            "postal_code": "326260869",
            "country_code": "US",
            "telephone_number": "352-490-7500",
            "fax_number": "352-490-7500",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CERSTVIK",
        "first_name": "JESSICA",
        "middle_name": "MARIE",
        "name_prefix": "Ms.",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-05",
        "last_updated": "2018-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "FL",
            "license": "12201",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Marys, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2018; 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.