Individual provider Active NPI

Jessica Lynn Botero, OTR/L

  • Occupational Therapist
  • Alpharetta, GA
National Provider Identifier
1639342876
Registry record updated Apr 9, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
OT004707 Issued in GA
Practice address
11940 Alpharetta Hwy
Suite 150
Alpharetta, GA 30004-2003
Phone
(770) 754-0085
Fax
(770) 754-9288
NPI assigned
Apr 9, 2008
Last updated
Apr 9, 2008By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 9, 2008

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 OT004707 GA Primary

Addresses

Primary practice location

11940 Alpharetta Hwy
Suite 150
Alpharetta, GA 30004-2003

Mailing address

11940 Alpharetta Hwy
Suite 150
Alpharetta, GA 30004-2003
Phone (770) 754-0085

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OT004707GAMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Integrated Rehabilitation Group, PC CurrentSince Jan 24, 2022 Accepting new patients
JLBR Care LLC Current Accepting new patients
Integrated Rehabilitation Group, PC Occupational Therapist CurrentSince Jan 24, 2022 Accepting new patients
Shelland Occupational Therapist Past Accepting new patients
Wexcom Inc Dba Sharon B Wexler Past Accepting new patients

Locations

10207 19th Ave SE
Everett, WA 98208
Phone (425) 337-3166

403 W Stanley St
Granite Falls, WA 98252
Phone (360) 691-4835

4220 132nd St SE
Ste 101
Mill Creek, WA 98012
Phone (425) 316-8046

Organizations & group practices 5

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

NPI Registry JSON

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

{
    "created_epoch": "1207699200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1207699200000",
    "number": "1639342876",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11940 ALPHARETTA HWY",
            "address_2": "SUITE 150",
            "city": "ALPHARETTA",
            "state": "GA",
            "postal_code": "300042003",
            "telephone_number": "770-754-0085",
            "fax_number": "770-754-9288"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11940 ALPHARETTA HWY",
            "address_2": "SUITE 150",
            "city": "ALPHARETTA",
            "state": "GA",
            "postal_code": "300042003",
            "telephone_number": "770-754-0085",
            "fax_number": "770-754-9288"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOTERO",
        "first_name": "JESSICA",
        "middle_name": "LYNN",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-04-09",
        "last_updated": "2008-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "GA",
            "license": "OT004707",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Alpharetta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2008; 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.