Individual provider Active NPI

Jessica Elizabeth Cook, MSOT, OTR/L

  • Occupational Therapist
  • La Grange, KY
National Provider Identifier
1639686439
Registry record updated Mar 26, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
175141 Issued in KY
Practice address
4603 Timberwalk CT
La Grange, KY 40031-6746
Phone
(502) 645-5075
NPI assigned
Jan 3, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 26, 2020

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 175141 KY Primary

Addresses

Primary practice location

4603 Timberwalk CT
La Grange, KY 40031-6746

Mailing address

3903 Heavenly Way
Louisville, KY 40272-2910
Phone (502) 645-5075

Other practice location 1

3903 Heavenly Way
Louisville, KY 40272-2910
Phone (502) 645-5075

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
175141KYMDOccupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1514937600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1585180800000",
    "number": "1639686439",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3903 HEAVENLY WAY",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402722910",
            "telephone_number": "502-645-5075"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4603 TIMBERWALK CT",
            "city": "LA GRANGE",
            "state": "KY",
            "postal_code": "400316746",
            "telephone_number": "502-645-5075"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3903 Heavenly Way",
            "address_purpose": "LOCATION",
            "city": "Louisville",
            "state": "KY",
            "postal_code": "402722910",
            "country_code": "US",
            "telephone_number": "502-645-5075",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "COOK",
        "first_name": "JESSICA",
        "middle_name": "ELIZABETH",
        "credential": "MSOT, OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-01-03",
        "last_updated": "2020-03-26",
        "certification_date": "2020-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "KY",
            "license": "175141",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in La Grange, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2020; 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.