Individual provider Active NPI

Jessica R Lyon

  • Occupational Therapist
  • Gallipolis, OH
National Provider Identifier
1649514712
Registry record updated Nov 15, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
OT.006757 Issued in OH
Practice address
1051 Fourth Avenue
Gallipolis, OH 45631
Phone
(740) 446-3560
Fax
(740) 441-9316
NPI assigned
Nov 15, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 15, 2012

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 OT.006757 OH Primary

Addresses

Primary practice location

1051 Fourth Avenue
Gallipolis, OH 45631

Mailing address

90 Jackson Pike
Gallipolis, OH 45631-1560
Phone (740) 446-3560

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
OT.006757OHMDOccupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1352937600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1352937600000",
    "number": "1649514712",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "90 JACKSON PIKE",
            "city": "GALLIPOLIS",
            "state": "OH",
            "postal_code": "456311560",
            "telephone_number": "740-446-3560",
            "fax_number": "740-441-9316"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1051 FOURTH AVENUE",
            "city": "GALLIPOLIS",
            "state": "OH",
            "postal_code": "45631",
            "telephone_number": "740-446-3560",
            "fax_number": "740-441-9316"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LYON",
        "first_name": "JESSICA",
        "middle_name": "R",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-11-15",
        "last_updated": "2012-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "OH",
            "license": "OT.006757",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gallipolis, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2012; 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.