Active NPI
Kathleen Leontine Jessen, OTR/L, IBCLC
- Feeding, Eating & Swallowing Occupational Therapist
- Roanoke, TX
National Provider Identifier
1669614905
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Feeding, Eating & Swallowing Occupational Therapist
- License
- 122278
- Practice address
- 11309 Dusty Trail CT
Roanoke, TX 76262-1927 - Phone
- (940) 208-9198
- NPI assigned
- Apr 1, 2009
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Lactation Consultant (Non-RN) | 174N00000X | L302117 | ||
| Occupational Therapist | 225X00000X | 122278 | TX | |
| Pediatric Occupational Therapist | 225XP0200X | 122278 | TX | |
| Feeding, Eating & Swallowing Occupational Therapist | 225XF0002X | 122278 | TX | Primary |
Addresses
Primary practice location
11309 Dusty Trail CT
Roanoke, TX 76262-1927
Mailing address
PO Box 1192
Argyle, TX 76226-1192
Phone (940) 208-9198
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
| License | State | Type | Specialty |
|---|---|---|---|
| 122278 | TX | MD | Speech-Language Pathologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Childrens Learning Connection, LLC | Pediatrics | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Speech-Language Pathologist
- Huntington Beach, CA
- NPI 1689723595
Pediatrics
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1238544000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1687392000000",
"number": "1669614905",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1192",
"city": "ARGYLE",
"state": "TX",
"postal_code": "762261192",
"telephone_number": "940-208-9198"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11309 DUSTY TRAIL CT",
"city": "ROANOKE",
"state": "TX",
"postal_code": "762621927",
"telephone_number": "940-208-9198"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JESSEN",
"first_name": "KATHLEEN",
"middle_name": "LEONTINE",
"credential": "OTR/L, IBCLC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2009-04-01",
"last_updated": "2023-06-22",
"certification_date": "2023-06-22",
"status": "A"
},
"taxonomies": [
{
"code": "174N00000X",
"taxonomy_group": "",
"desc": "Lactation Consultant, Non-RN",
"state": null,
"license": "L302117",
"primary": false
},
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "TX",
"license": "122278",
"primary": false
},
{
"code": "225XP0200X",
"taxonomy_group": "",
"desc": "Occupational Therapist, Pediatrics",
"state": "TX",
"license": "122278",
"primary": false
},
{
"code": "225XF0002X",
"taxonomy_group": "",
"desc": "Occupational Therapist, Feeding, Eating & Swallowing",
"state": "TX",
"license": "122278",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Roanoke, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.