Jordyn Alese Phelps, COTA/L

Primary specialty

Occupational Therapy AssistantTaxonomy code 224Z00000X

License

1342 Issued in ND

Practice address

683 State Ave
B
Dickinson, ND 58601-4660

Phone

(701) 483-9400

NPI assigned

Oct 7, 2016

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Jordyn Alese Braun Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

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.

• Omaha Therapy Dba Rehab Visions

  • Physical Therapist
  • Dickinson, ND
  • NPI 1457513418
  NPD (past)
• Omaha Therapy, Inc

  • Rehabilitation Clinic/Center
  • Dickinson, ND
  • NPI 1730280371
  NPD (past)

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

{
    "created_epoch": "1475798400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1606953600000",
    "number": "1649720152",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1958 1ST ST W",
            "city": "DICKINSON",
            "state": "ND",
            "postal_code": "586012426",
            "telephone_number": "701-640-9812"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "683 STATE AVE",
            "address_2": "B",
            "city": "DICKINSON",
            "state": "ND",
            "postal_code": "586014660",
            "telephone_number": "701-483-9400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHELPS",
        "first_name": "JORDYN",
        "middle_name": "ALESE",
        "credential": "COTA/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-10-07",
        "last_updated": "2020-12-03",
        "certification_date": "2020-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "ND",
            "license": "1342",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JORDYN",
            "last_name": "BRAUN",
            "middle_name": "ALESE",
            "credential": "COTA/L",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Brody William Peterson
• Gary D Peterson, MD
• Kami L Peterson, BSN, RN, FNP-C
• Shantelle Lace Petroff
• Annah Peyiye
• Linda R Plaggemeyer
• Playfully You, PLLC
• Pokorny Chiropractic Clinic, PC
• David C Pokorny, D.C
• Jeffrey D Pokorny, D.C

• All providers in Dickinson, ND
• Occupational Therapy Assistant in North Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 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.