Individual provider Active NPI

James Lester Daniels Jr., OTR

  • Home Health Agency
  • Jacksonville, FL
National Provider Identifier
1639310956
Registry record updated Sep 17, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
License
1467 Issued in FL
Practice address
841 Prudential Dr # 12TH
Jacksonville, FL 32207-8329
Phone
(904) 469-4390
NPI assigned
Mar 17, 2009
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 17, 2021

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 OT10567 FL
Home Health Agency 251E00000X 1467 FL Primary

Addresses

Primary practice location

841 Prudential Dr # 12TH
Jacksonville, FL 32207-8329

Mailing address

841 Prudential Dr # 12TH
Jacksonville, FL 32207-8329
Phone (904) 469-4390

Other practice location 1

1933 River Rock Rd
Jacksonville, FL 32221-8084
Phone (904) 343-2557

Other identifiers 3

IdentifierTypeStateIssuer
1467OtherFLSTAFFING
1467OtherSTAFFING
26-4133310OtherFLSTAFFING

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230328000515 FL Practitioner - Occupational Therapist in Private Practice 9537533864 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Therapyworks of Jacksonville IncGroup PAC ID 2163588765, 2 clinicians

Practice addresses (Care Compare)

2535 University Blvd W
Jacksonville, FL 32217-2003
Phone (904) 348-5511

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1467FLMDVeterinarian
OT10567FLMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Therapyworks of Jacksonville Inc Occupational Therapist CurrentSince Dec 2, 2022 Accepting new patients

Locations

2535 University Blvd W
Jacksonville, FL 32217
Phone (904) 348-5511

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1237248000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631836800000",
    "number": "1639310956",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "841 PRUDENTIAL DR # 12TH",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322078329",
            "telephone_number": "904-469-4390",
            "fax_number": "904-551-6449"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "841 PRUDENTIAL DR # 12TH",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322078329",
            "telephone_number": "904-469-4390"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1933 River Rock Rd",
            "address_purpose": "LOCATION",
            "city": "Jacksonville",
            "state": "FL",
            "postal_code": "322218084",
            "country_code": "US",
            "telephone_number": "904-343-2557",
            "fax_number": "904-551-6449",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DANIELS",
        "first_name": "JAMES",
        "middle_name": "LESTER",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "credential": "OTR",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-03-17",
        "last_updated": "2021-09-17",
        "certification_date": "2021-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "FL",
            "license": "OT10567",
            "primary": false
        },
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "FL",
            "license": "1467",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STAFFING",
            "identifier": "1467",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STAFFING",
            "identifier": "1467",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STAFFING",
            "identifier": "26-4133310",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2021; 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.