Individual provider Active NPI

Jamie Hillesland, OT

  • Occupational Therapist
  • West Fargo, ND
National Provider Identifier
1659596096
Registry record updated Feb 1, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
222 Issued in ND
Practice address
415 32ND Ave E
West Fargo, ND 58078-7923
Phone
(701) 740-7876
NPI assigned
Apr 13, 2007
Last updated
Feb 1, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 1, 2021

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 222 ND Primary

Addresses

Primary practice location

415 32ND Ave E
West Fargo, ND 58078-7923

Mailing address

621 Evergreen Dr
Grand Forks, ND 58201-8088
Phone (701) 740-7876

Other practice location 1

2424 32nd Ave S. Ste 103
Grand Forks, ND 58201-6509
Phone (701) 746-8374

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110223000566 ND Practitioner - Occupational Therapist in Private Practice 0547441685 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

415 32ND Ave E
West Fargo, ND 58078-7923

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
222NDMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Achieve Therapy LLC CurrentSince Apr 1, 2017 Accepting new patients
Hand Therapy Associates, PLLC Occupational Therapist CurrentSince Dec 10, 2020 Accepting new patients
Achieve Therapy LLC Occupational Therapist CurrentSince Apr 1, 2017 Accepting new patients
Rehabauthority, LLC Occupational Therapist CurrentSince May 1, 2015 Accepting new patients

Locations

1560 S Carol St
Meridian, ID 83646
Phone (208) 495-4317

3170 43rd St S
Ste 101
Fargo, ND 58104
Phone (701) 277-8448

2424 32nd Ave S
Ste 103
Grand Forks, ND 58201
Phone (701) 792-6700

3035 Demers Ave
Grand Forks, ND 58201
Phone (701) 746-6694

701 Demers Ave
#B
Grand Forks, ND 58201
Phone (701) 772-2200

415 32nd Ave E
West Fargo, ND 58078
Phone (701) 740-7876

415 32nd Ave E
Ste B
West Fargo, ND 58078
Phone (701) 740-7876

Organizations & group practices 4

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": "1176422400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1612137600000",
    "number": "1659596096",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "621 EVERGREEN DR",
            "city": "GRAND FORKS",
            "state": "ND",
            "postal_code": "582018088",
            "telephone_number": "701-740-7876"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "415 32ND AVE E",
            "city": "WEST FARGO",
            "state": "ND",
            "postal_code": "580787923",
            "telephone_number": "701-740-7876"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2424 32nd Ave S. Ste 103",
            "address_purpose": "LOCATION",
            "city": "Grand Forks",
            "state": "ND",
            "postal_code": "582016509",
            "country_code": "US",
            "telephone_number": "701-746-8374",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HILLESLAND",
        "first_name": "JAMIE",
        "name_prefix": "Ms.",
        "credential": "OT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-13",
        "last_updated": "2021-02-01",
        "certification_date": "2020-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "ND",
            "license": "222",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Fargo, ND

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 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.