Jacob Andrew Belloli, OTR/L

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

OT-2592 Issued in ID

Practice address

120 E Howard St
Driggs, ID 83422-5112

Phone

(208) 354-2383

NPI assigned

Sep 16, 2024

Last updated

Sep 16, 2024By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1726444800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726444800000",
    "number": "1669209532",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "759 N SKYLINE DR",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834022663",
            "telephone_number": "209-345-6270"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 E HOWARD ST",
            "city": "DRIGGS",
            "state": "ID",
            "postal_code": "834225112",
            "telephone_number": "208-354-2383"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "660 S 2nd W",
            "address_purpose": "LOCATION",
            "city": "Rexburg",
            "state": "ID",
            "postal_code": "834402300",
            "country_code": "US",
            "telephone_number": "208-356-0220",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3111 Channing Way",
            "address_purpose": "LOCATION",
            "city": "Idaho Falls",
            "state": "ID",
            "postal_code": "834047534",
            "country_code": "US",
            "telephone_number": "208-529-0067",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BELLOLI",
        "first_name": "JACOB",
        "middle_name": "ANDREW",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-09-16",
        "last_updated": "2024-09-16",
        "certification_date": "2024-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "ID",
            "license": "OT-2592",
            "primary": true
        },
        {
            "code": "225XG0600X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Gerontology",
            "state": "ID",
            "license": "OT-2592",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Morgan G Barkdull, D.C.
• Deborah L. Barros, ACNP
• Michael Douglass Barton, DPT
• Judy M Baumgardner, MS PT
• Nicholas Kevin Beebe, PHARMD
• Lanie Benson
• Karlin L Bilcher, LPC, M. DIV
• Alexis Blaser, MS, RDN, LD
• Michael P Bleffert, PT
• Blue Zone Healthcare LLC

• Occupational Therapist in Driggs, ID
• Providers in Driggs, ID by specialty
• Occupational Therapist in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2024; 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.