Jessica Elizabeth Lane, OTR/L

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

31007603A Issued in IN

Practice address

751 W 2ND St Ste 200
Peru, IN 46970-1385

Phone

(765) 919-4444

NPI assigned

Mar 23, 2017

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other names 1

• Jessica Elizabeth Roller Former name

Medicare fee-for-service enrollment

Enrolled in IN

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Ivyrehab Physical Therapy, Occupational Therapy & Speech Language Path

  • Physical Therapist
  • Peru, IN
  • NPI 1750764494

  Occupational Therapist

  Medicare reassignment NPD
• Ivyrehab Physical Therapy, Occupational Therapy & Speech Language Pathology, PLLC

  • Physical Medicine & Rehabilitation Physician
  • New York, NY
  • NPI 1215637699
  NPD

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

{
    "created_epoch": "1490227200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661990400000",
    "number": "1629509427",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "519 YORK RD",
            "city": "GALVESTON",
            "state": "IN",
            "postal_code": "469329775",
            "telephone_number": "765-480-8161"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "751 W 2ND ST STE 200",
            "city": "PERU",
            "state": "IN",
            "postal_code": "469701385",
            "telephone_number": "765-919-4444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LANE",
        "first_name": "JESSICA",
        "middle_name": "ELIZABETH",
        "credential": "OTR/L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-03-23",
        "last_updated": "2022-09-01",
        "certification_date": "2022-09-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "IN",
            "license": "32003154A",
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "IN",
            "license": "31007603A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JESSICA",
            "last_name": "ROLLER",
            "middle_name": "ELIZABETH",
            "credential": "OTR/L COTA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Kroger Limited Partnership I (Kroger Pharmacy)
• Carmen Kuhn, OTR
• Dugan Thomas Labarge, DDS
• Ladd Dental Group of Peru, P.C.
• Ladd Dental of Bunker Hill P.C.
• Larsen Chiropractic Inc
• Mark William Larsen, DC
• Mattie L Lawson
• Edward A Lebrija, DPM
• Lancia K Lee, BGS

• Occupational Therapist in Peru, IN
• Providers in Peru, IN by specialty
• Occupational Therapist in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.