Individual provider Active NPI

Jessica Rylant Gibson, M.S.,OTR/L

  • Pediatric Occupational Therapist
  • Montgomery, AL
National Provider Identifier
1619103603
Registry record updated Aug 27, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Occupational TherapistTaxonomy code 225XP0200X
License
2984 Issued in AL
Practice address
4209 Carmichael Rd
Montgomery, AL 36106-3601
Phone
(334) 356-1020
Fax
(334) 356-2177
NPI assigned
Jun 3, 2009
Last updated
Aug 27, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 27, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 2984 AL
Pediatric Occupational Therapist 225XP0200X 2984 AL Primary

Addresses

Primary practice location

4209 Carmichael Rd
Montgomery, AL 36106-3601

Mailing address

4758 Grier Rd
Wetumpka, AL 36092-6105
Phone (334) 590-0164

Other names 1

  • Miss Jessica Nicole Rylant Former name

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
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
2984ALMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Grace Circle, LLC Pediatrics CurrentSince Apr 21, 2024 Accepting new patients

Locations

4209 Carmichael Rd
Montgomery, AL 36106
Phone (334) 356-1020

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": "1243987200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1756252800000",
    "number": "1619103603",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4758 GRIER RD",
            "city": "WETUMPKA",
            "state": "AL",
            "postal_code": "360926105",
            "telephone_number": "334-590-0164"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4209 CARMICHAEL RD",
            "city": "MONTGOMERY",
            "state": "AL",
            "postal_code": "361063601",
            "telephone_number": "334-356-1020",
            "fax_number": "334-356-2177"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GIBSON",
        "first_name": "JESSICA",
        "middle_name": "RYLANT",
        "name_prefix": "Mrs.",
        "credential": "M.S.,OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-06-03",
        "last_updated": "2025-08-27",
        "certification_date": "2025-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "AL",
            "license": "2984",
            "primary": false
        },
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "AL",
            "license": "2984",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JESSICA",
            "last_name": "RYLANT",
            "middle_name": "NICOLE",
            "prefix": "MISS",
            "credential": "M.S., OTR/L",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Montgomery, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2025; 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.