Individual provider Active NPI

Jaimie Lynn Washofer, OTR

  • Occupational Therapist
  • Waldwick, NJ
National Provider Identifier
1629471578
Registry record updated Oct 7, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
11382 Issued in MA
Practice address
50 Evergreen St
Waldwick, NJ 07463-1421
Phone
(201) 741-5509
NPI assigned
Oct 7, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 7, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 11382 MA Primary

Addresses

Primary practice location

50 Evergreen St
Waldwick, NJ 07463-1421

Mailing address

50 Evergreen St
Waldwick, NJ 07463-1421
Phone (201) 741-5509

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230103002330 NC Practitioner - Occupational Therapist in Private Practice 5597135830 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Paragon Outpatient Rehabilitation Services LLCGroup PAC ID 8022272848, 199 clinicians

Practice addresses (Care Compare)

1195 Drake Mill LN SW
Concord, NC 28025-8561
Phone (704) 260-0391

3150 Burke Mill Rd
RM 200
Winston Salem, NC 27103-6431
Phone (336) 397-4200

4968 Milestone Ave
Kannapolis, NC 28081-4503
Phone (704) 994-5250

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
11382MAMDMusic Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Paragon Outpatient Rehabilitation Services, LLC CurrentSince Sep 8, 2022 Accepting new patients
Paragon Outpatient Rehabilitation Services, LLC CurrentSince Sep 8, 2022 Accepting new patients

Locations

1195 Drake Mill Ln SW
Concord, NC 28025
Phone (704) 251-2602

2605 Swallow Rd
Rm 201
Reidsville, NC 27320
Phone (704) 251-2602

Organizations & group practices 2

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": "1412640000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1412640000000",
    "number": "1629471578",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "50 EVERGREEN ST",
            "city": "WALDWICK",
            "state": "NJ",
            "postal_code": "074631421",
            "telephone_number": "201-741-5509"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "50 EVERGREEN ST",
            "city": "WALDWICK",
            "state": "NJ",
            "postal_code": "074631421",
            "telephone_number": "201-741-5509"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WASHOFER",
        "first_name": "JAIMIE",
        "middle_name": "LYNN",
        "credential": "OTR",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-10-07",
        "last_updated": "2014-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "MA",
            "license": "11382",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waldwick, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2014; 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.