Active NPI
Mary Jurak
- Occupational Therapy Assistant
- Avon, OH
National Provider Identifier
1720524440
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapy Assistant
- License
- OTA.02570
- Practice address
- 3075 Stoney Ridge Rd
Avon, OH 44011-1821 - Phone
- (440) 934-5124
- NPI assigned
- Jan 19, 2017
- 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 Therapy Assistant | 224Z00000X | OTA.02570 | OH | Primary |
Addresses
Primary practice location
3075 Stoney Ridge Rd
Avon, OH 44011-1821
Mailing address
3480 Archwood Dr
Rocky River, OH 44116-3704
Phone (440) 333-1295
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 |
|---|---|---|---|
| OTA.02570 | OH | MD | Occupational Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1484784000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1484784000000",
"number": "1720524440",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3480 ARCHWOOD DR",
"city": "ROCKY RIVER",
"state": "OH",
"postal_code": "441163704",
"telephone_number": "440-333-1295"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3075 STONEY RIDGE RD",
"city": "AVON",
"state": "OH",
"postal_code": "440111821",
"telephone_number": "440-934-5124"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JURAK",
"first_name": "MARY",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2017-01-19",
"last_updated": "2017-01-19",
"status": "A"
},
"taxonomies": [
{
"code": "224Z00000X",
"taxonomy_group": "",
"desc": "Occupational Therapy Assistant",
"state": "OH",
"license": "OTA.02570",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Avon, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.