Active NPI
Shannon L Jacoby, OTR
- Occupational Therapist
- Defiance, OH
National Provider Identifier
1730412099
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- OT007374
- Practice address
- 1400 E 2ND St
Defiance, OH 43512-2440 - Phone
- (419) 783-1414
- Fax
- (419) 784-2799
- NPI assigned
- Sep 17, 2009
- 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 | OT007374 | OH | Primary |
Addresses
Primary practice location
1400 E 2ND St
Defiance, OH 43512-2440
Mailing address
1400 E 2ND St
Defiance, OH 43512-2440
Phone (419) 784-1414
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)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Cornerstone Rehabilitation LTD | Occupational Therapist | Past | Accepting new patients |
Interoperability endpoints
- sjacoby183495@direct.bsmhealth.org
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1253145600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1439769600000",
"number": "1730412099",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1400 E 2ND ST",
"city": "DEFIANCE",
"state": "OH",
"postal_code": "435122440",
"telephone_number": "419-784-1414"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1400 E 2ND ST",
"city": "DEFIANCE",
"state": "OH",
"postal_code": "435122440",
"telephone_number": "419-783-1414",
"fax_number": "419-784-2799"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JACOBY",
"first_name": "SHANNON",
"middle_name": "L",
"credential": "OTR",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-09-17",
"last_updated": "2015-08-17",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "OH",
"license": "OT007374",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Defiance, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.