Active NPI
Jesse Mercado, OT
- Occupational Therapist
- Windsor, CO
National Provider Identifier
1497213144
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 0004212
- Practice address
- 561 E Garden Dr Unit B
Windsor, CO 80550-3149 - Phone
- (630) 768-5947
- NPI assigned
- Mar 12, 2019
- Sex
- Male
- Sole proprietor
- No
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 Therapist | 225X00000X | 0004212 | CO | Primary |
Addresses
Primary practice location
561 E Garden Dr Unit B
Windsor, CO 80550-3149
Mailing address
561 E Garden Dr Unit B
Windsor, CO 80550-3149
Phone (630) 768-5947
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
| License | State | Type | Specialty |
|---|---|---|---|
| 0004212 | CO | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1552348800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1552348800000",
"number": "1497213144",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "561 E GARDEN DR UNIT B",
"city": "WINDSOR",
"state": "CO",
"postal_code": "805503149",
"telephone_number": "630-768-5947"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "561 E GARDEN DR UNIT B",
"city": "WINDSOR",
"state": "CO",
"postal_code": "805503149",
"telephone_number": "630-768-5947"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MERCADO",
"first_name": "JESSE",
"credential": "OT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2019-03-12",
"last_updated": "2019-03-12",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "CO",
"license": "0004212",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Windsor, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 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.