Stephanie Jenae Dortch, OTR/L

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

OT3608 Issued in MS

Practice address

809 Windlass CV
Brandon, MS 39047-7035

Phone

(601) 720-7206

NPI assigned

Mar 6, 2015

Last updated

Sep 20, 2021By 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 2

Addresses

Other names 1

• Miss Stephanie Jenae Robinson Former name

Medicare fee-for-service enrollment

Enrolled in MS

Enrollment records 1

Specialty

Occupational Therapist in Private Practice

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Healing Hands Rehabilitation Services LLCGroup PAC ID 3072881267, 3 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Healing Hands Rehabilitation Services, LLC

  • Physical Therapy Clinic/Center
  • Madison, MS
  • NPI 1346629920
  Medicare reassignment Care Compare group NPD
• Healing Hands Rehabilitation Services, LLC

  • Behavior Analyst
  • Gluckstadt, MS
  • NPI 1609691963
  NPD

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

{
    "created_epoch": "1425600000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632096000000",
    "number": "1487047080",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5155 KAYWOOD CIR",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392114609",
            "telephone_number": "601-594-8242"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "809 WINDLASS CV",
            "city": "BRANDON",
            "state": "MS",
            "postal_code": "390477035",
            "telephone_number": "601-720-7206"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DORTCH",
        "first_name": "STEPHANIE",
        "middle_name": "JENAE",
        "name_prefix": "Mrs.",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-03-06",
        "last_updated": "2021-09-20",
        "certification_date": "2021-09-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "MS",
            "license": "TA2010",
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "MS",
            "license": "OT3608",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "STEPHANIE",
            "last_name": "ROBINSON",
            "middle_name": "JENAE",
            "prefix": "MISS",
            "credential": "COTA/L",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Occupational Therapist in Brandon, MS
• Providers in Brandon, MS by specialty
• Occupational Therapist in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.