Jessica Comstock, COTA/L

Primary specialty

Occupational Therapy AssistantTaxonomy code 224Z00000X

License

057003879 Issued in IL

Practice address

620 Warrington Ave
Danville, IL 61832-5446

Phone

(217) 649-5209

NPI assigned

Dec 2, 2022

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

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1669939200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1669939200000",
    "number": "1619687456",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1573 E 750 NORTH RD",
            "city": "CISSNA PARK",
            "state": "IL",
            "postal_code": "609248778"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "620 WARRINGTON AVE",
            "city": "DANVILLE",
            "state": "IL",
            "postal_code": "618325446",
            "telephone_number": "217-649-5209"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COMSTOCK",
        "first_name": "JESSICA",
        "credential": "COTA/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-12-02",
        "last_updated": "2022-12-02",
        "certification_date": "2022-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "IL",
            "license": "057003879",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "NONE",
            "state": "IL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jessicacomstock@selectrehab.com",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "620 Warrington Ave",
            "city": "Danville",
            "state": "IL",
            "country_code": "US",
            "postal_code": "618325446",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Brandice Connor, BS
• Jasmine Conyers
• Donna N. Cook
• Kristen Elizabeth Cooley
• Dorothy Jane Cooney, DDS

• Occupational Therapy Assistant in Danville, IL
• Providers in Danville, IL by specialty
• Occupational Therapy Assistant in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 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.