Individual provider Active NPI

Jacalyn Mitchell-Stephens

  • Occupational Therapy Assistant
  • Houston, TX
National Provider Identifier
1710461082
Registry record updated Sep 21, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Therapy AssistantTaxonomy code 224Z00000X
License
201051 Issued in TX
Practice address
9430 Ashville Dr
Houston, TX 77051-3206
Phone
(713) 444-6992
NPI assigned
Sep 21, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 21, 2018

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 201051 TX Primary

Addresses

Primary practice location

9430 Ashville Dr
Houston, TX 77051-3206

Mailing address

9430 Ashville Dr
Houston, TX 77051-3206

Other identifiers 1

IdentifierTypeStateIssuer
201051OtherTXTEXAS BOARD OTA STATE LICENSE

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
201051TXMDOccupational Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1537488000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1537488000000",
    "number": "1710461082",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9430 ASHVILLE DR",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770513206"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9430 ASHVILLE DR",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770513206",
            "telephone_number": "713-444-6992"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MITCHELL-STEPHENS",
        "first_name": "JACALYN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-09-21",
        "last_updated": "2018-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "TX",
            "license": "201051",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TEXAS BOARD OTA STATE LICENSE",
            "identifier": "201051",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2018; 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.