Individual provider Active NPI

Yahsmin Rashe Sojourney, COTA

  • Occupational Therapy Assistant
  • Hollandale, MS
National Provider Identifier
1699428656
Registry record updated Jan 31, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Therapy AssistantTaxonomy code 224Z00000X
License
TA3014 Issued in MS
Practice address
29 Susie B Law Rd
Hollandale, MS 38748-9710
Phone
(601) 850-7634
Fax
(360) 368-6227
NPI assigned
Jan 31, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 31, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy Assistant 224Z00000X TA3014 MS Primary

Addresses

Primary practice location

29 Susie B Law Rd
Hollandale, MS 38748-9710

Mailing address

29 Susie B Law Rd
Hollandale, MS 38748-9710
Phone (601) 850-7634

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

LicenseStateTypeSpecialty
TA3014MSMDOccupational Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Nichols Occupational Therapy PLLC CurrentSince Feb 6, 2022 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.

NPI Registry JSON

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

{
    "created_epoch": "1643587200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643587200000",
    "number": "1699428656",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29 SUSIE B LAW RD",
            "city": "HOLLANDALE",
            "state": "MS",
            "postal_code": "387489710",
            "telephone_number": "601-850-7634",
            "fax_number": "360-368-6227"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "29 SUSIE B LAW RD",
            "city": "HOLLANDALE",
            "state": "MS",
            "postal_code": "387489710",
            "telephone_number": "601-850-7634",
            "fax_number": "360-368-6227"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOJOURNEY",
        "first_name": "YAHSMIN",
        "middle_name": "RASHE",
        "credential": "COTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-01-31",
        "last_updated": "2022-01-31",
        "certification_date": "2022-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "MS",
            "license": "TA3014",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hollandale, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2022; 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.