Active NPI
Laura Charlotte Jacobs, OTR
- Occupational Therapist
- Bluefield, VA
National Provider Identifier
1679794358
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 0119003857
- Practice address
- 20 Westwood Medical Park
Bluefield, VA 24605-2003 - Phone
- (276) 322-5439
- NPI assigned
- May 1, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 0119003857 | VA | Primary |
Addresses
Primary practice location
20 Westwood Medical Park
Bluefield, VA 24605-2003
Mailing address
106 Callaway Cir
Bluefield, VA 24605-9702
Phone (276) 322-1976
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 |
|---|---|---|---|
| 0119003857 | VA | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1177977600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1679794358",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "106 CALLAWAY CIR",
"city": "BLUEFIELD",
"state": "VA",
"postal_code": "246059702",
"telephone_number": "276-322-1976"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "20 WESTWOOD MEDICAL PARK",
"city": "BLUEFIELD",
"state": "VA",
"postal_code": "246052003",
"telephone_number": "276-322-5439"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JACOBS",
"first_name": "LAURA",
"middle_name": "CHARLOTTE",
"name_prefix": "Mrs.",
"credential": "OTR",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-05-01",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "VA",
"license": "0119003857",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bluefield, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.