Miranda E Jacobs, OTA

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

2454 Issued in OK

Practice address

117 W 5TH St Ste 100
Bartlesville, OK 74003-6615

Phone

(918) 203-3313

NPI assigned

Sep 28, 2022

Last updated

Sep 28, 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

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Bartlesville Pediatric Occupational Therapy, LLC

  dba : Bartlesville Hope Pediatric Clinic

  • Pediatric Occupational Therapist
  • Bartlesville, OK
  • NPI 1285298604
  NPD (past)

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

{
    "created_epoch": "1664323200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664323200000",
    "number": "1497479935",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "117 W 5TH ST STE 100",
            "city": "BARTLESVILLE",
            "state": "OK",
            "postal_code": "740036615",
            "telephone_number": "918-203-3313",
            "fax_number": "918-512-4082"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "117 W 5TH ST STE 100",
            "city": "BARTLESVILLE",
            "state": "OK",
            "postal_code": "740036615",
            "telephone_number": "918-203-3313"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACOBS",
        "first_name": "MIRANDA",
        "middle_name": "E",
        "credential": "OTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-09-28",
        "last_updated": "2022-09-28",
        "certification_date": "2022-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "OK",
            "license": "2454",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Consensus",
            "affiliation": "N",
            "endpointDescription": "fax",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "117 W 5th St Ste 100",
            "city": "Bartlesville",
            "state": "OK",
            "country_code": "US",
            "postal_code": "740036615",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Internal Medicine of Bartlesville PLLC
• Itr Counseling, PLLC
• Stephen Tyrell Ivey
• Darian Nichole Jackson
• Sherry Ann Jackson, RD
• James E . Webb, Jr., DPM, PC
• Jamie Archer Bennett, OD,PC
• Erin Jamison-Bell
• Ealachelvi Janarthanan, DDS
• Jane Phillips Memorial Medical Center Inc (Ascension Rx 1600)

• Occupational Therapist in Bartlesville, OK
• Providers in Bartlesville, OK by specialty
• Occupational Therapist in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 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.