Active NPI
Rachel Jordan Timmons, OTD
- Occupational Therapist
- Marion, IN
National Provider Identifier
1750675567
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 31005169A
- Practice address
- 1320 W Spencer Ave
Marion, IN 46952-3415 - Phone
- (765) 662-0490
- Fax
- (765) 662-0853
- NPI assigned
- Jun 9, 2011
- 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 | 31005169A | IN | Primary |
Addresses
Primary practice location
1320 W Spencer Ave
Marion, IN 46952-3415
Mailing address
700 E. Firmin Street
Suite 209
Kokomo, IN 46902-2375
Phone (765) 454-9748
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 31005169A | Other | IN | OCCUPATIONAL THERAPY 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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 31005169A | IN | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1307577600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1418083200000",
"number": "1750675567",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "700 E. FIRMIN STREET",
"address_2": "SUITE 209",
"city": "KOKOMO",
"state": "IN",
"postal_code": "469022375",
"telephone_number": "765-454-9748",
"fax_number": "765-450-6664"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1320 W SPENCER AVE",
"city": "MARION",
"state": "IN",
"postal_code": "469523415",
"telephone_number": "765-662-0490",
"fax_number": "765-662-0853"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TIMMONS",
"first_name": "RACHEL",
"middle_name": "JORDAN",
"name_prefix": "Dr.",
"credential": "OTD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-06-09",
"last_updated": "2014-12-09",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "IN",
"license": "31005169A",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "OCCUPATIONAL THERAPY LICENSE",
"identifier": "31005169A",
"state": "IN"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Marion, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.