Jacqueline Eckes, COTA

Primary specialty

Occupational Therapy AssistantTaxonomy code 224Z00000X

License

484827 Issued in WI

Practice address

4879 3Rd St
Vesper, WI 54489-9412

Phone

(715) 213-4406

NPI assigned

Mar 1, 2013

Last updated

Mar 1, 2013By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1362096000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1362096000000",
    "number": "1740520675",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4879 3RD ST",
            "city": "VESPER",
            "state": "WI",
            "postal_code": "544899412"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4879 3RD ST",
            "city": "VESPER",
            "state": "WI",
            "postal_code": "544899412",
            "telephone_number": "715-213-4406"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ECKES",
        "first_name": "JACQUELINE",
        "credential": "COTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-03-01",
        "last_updated": "2013-03-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "WI",
            "license": "484827",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Miranda J Nieman
• Jennifer Jo Ott, RN
• Terry Pelot, OTR
• Clarissa M Simonson, DNP, AGNP-C, APNP

• Occupational Therapy Assistant in Vesper, WI
• Providers in Vesper, WI by specialty
• Occupational Therapy Assistant in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 1, 2013; 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.