Active NPI
Jessica Anderson
- Occupational Therapist
- Booneville, KY
National Provider Identifier
1699239236
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- BOTOCT00195835
- Practice address
- 20 County Barn Rd
Booneville, KY 41314-6500 - Phone
- (606) 593-6302
- NPI assigned
- Jan 28, 2019
- Last updated
- Jan 28, 2019
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | BOTOCT00195835 | KY | Primary |
Addresses
Primary practice location
20 County Barn Rd
Booneville, KY 41314-6500
Mailing address
105 Popular LN
Manchester, KY 40962-6000
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 |
|---|---|---|---|
| BOTOCT00195835 | KY | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1548633600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1548633600000",
"number": "1699239236",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "105 POPULAR LN",
"city": "MANCHESTER",
"state": "KY",
"postal_code": "409626000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "20 COUNTY BARN RD",
"city": "BOONEVILLE",
"state": "KY",
"postal_code": "413146500",
"telephone_number": "606-593-6302"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ANDERSON",
"first_name": "JESSICA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2019-01-28",
"last_updated": "2019-01-28",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Occupational Therapist",
"state": "KY",
"license": "BOTOCT00195835",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Booneville, KY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.