Individual provider Active NPI

Jessica Lynne Taylor, MS OTR/L

  • Occupational Therapist
  • Marietta, GA
National Provider Identifier
1619210440
Registry record updated May 14, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
OT006996 Issued in GA
Practice address
5233 Shasta Way
Marietta, GA 30062-6545
Phone
(305) 283-5986
NPI assigned
Mar 29, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 14, 2020

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 OT15573 FL
Occupational Therapist 225X00000X OT006996 GA Primary

Addresses

Primary practice location

5233 Shasta Way
Marietta, GA 30062-6545

Mailing address

5233 Shasta Way
Marietta, GA 30062-6545
Phone (305) 283-5986

Other practice location 1

10451 SW 157th Pl
apt 208
Miami, FL 33196-4551
Phone (305) 283-5986

Other names 1

  • Jessica Lynne Sardinas Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20191122002075 GA Practitioner - Occupational Therapist in Private Practice 2466884804 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Empowerme Rehabilitation Georgia, LLCGroup PAC ID 4284063835, 80 clinicians

Practice addresses (Care Compare)

5610 Hampton Park Dr
Cumming, GA 30041-4004
Phone (470) 866-5540

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
OT15573FLMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Onr National Speech Pathology Inc CurrentSince Aug 15, 2021 Accepting new patients
Fox Rehabilitation Ga, LLC Occupational Therapist CurrentSince Oct 1, 2019 Accepting new patients
Empowerme Rehabilitation Georgia, LLC Occupational Therapist CurrentSince Feb 1, 2024 Accepting new patients

Locations

5610 Hampton Park Dr
Cumming, GA 30041
Phone (470) 866-5540

1335 Strassner Dr
Saint Louis, MO 63144
Phone (314) 673-6723

8500 Bluffstone Cv
Ste A201
Austin, TX 78759
Phone (512) 220-5252

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1364515200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1589414400000",
    "number": "1619210440",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5233 SHASTA WAY",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300626545",
            "telephone_number": "305-283-5986"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5233 SHASTA WAY",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300626545",
            "telephone_number": "305-283-5986"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10451 SW 157th Pl",
            "address_2": "apt 208",
            "address_purpose": "LOCATION",
            "city": "Miami",
            "state": "FL",
            "postal_code": "331964551",
            "country_code": "US",
            "telephone_number": "305-283-5986",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TAYLOR",
        "first_name": "JESSICA",
        "middle_name": "LYNNE",
        "name_prefix": "Mrs.",
        "credential": "MS OTR/L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-03-29",
        "last_updated": "2020-05-14",
        "certification_date": "2020-05-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "FL",
            "license": "OT15573",
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "GA",
            "license": "OT006996",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JESSICA",
            "last_name": "SARDINAS",
            "middle_name": "LYNNE",
            "credential": "MS OTR/L",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Marietta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 2020; 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.