Active NPI
Stephanie Ann Jickess, MS, OTR/L
- Occupational Therapist
- Cleveland, OH
National Provider Identifier
1730732173
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- OT010713
- Practice address
- 10701 East Blvd
Cleveland, OH 44106-1702 - Phone
- (216) 791-3800
- NPI assigned
- Jul 23, 2019
- 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 | OT010713 | OH | Primary |
Addresses
Primary practice location
10701 East Blvd
Cleveland, OH 44106-1702
Mailing address
500 E Regency Cir
Canfield, OH 44406-9643
Phone (330) 502-0000
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
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| OT010713 | OH | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1563840000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1576454400000",
"number": "1730732173",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "500 E REGENCY CIR",
"city": "CANFIELD",
"state": "OH",
"postal_code": "444069643",
"telephone_number": "330-502-0000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10701 EAST BLVD",
"city": "CLEVELAND",
"state": "OH",
"postal_code": "441061702",
"telephone_number": "216-791-3800"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JICKESS",
"first_name": "STEPHANIE",
"middle_name": "ANN",
"credential": "MS, OTR/L",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-07-23",
"last_updated": "2019-12-16",
"certification_date": "2019-12-16",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "OH",
"license": "OT010713",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Cleveland, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 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.