Active NPI
Jodie Marie Gipson, OTR/L
- Occupational Therapist
- Chicago, IL
National Provider Identifier
1770824237
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 056.009860
- Practice address
- 1346 N Bosworth Ave
Unit 3
Chicago, IL 60642-2393 - Phone
- (573) 837-2289
- NPI assigned
- Mar 8, 2013
- 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 Therapist | 225X00000X | 056.009860 | IL | Primary |
Addresses
Primary practice location
1346 N Bosworth Ave
Unit 3
Chicago, IL 60642-2393
Mailing address
1346 N Bosworth Ave
Unit 3
Chicago, IL 60642-2393
Phone (573) 837-2289
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 |
|---|---|---|---|
| 056.009860 | IL | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1362700800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1362700800000",
"number": "1770824237",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1346 N BOSWORTH AVE",
"address_2": "UNIT 3",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606422393",
"telephone_number": "573-837-2289"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1346 N BOSWORTH AVE",
"address_2": "UNIT 3",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606422393",
"telephone_number": "573-837-2289"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GIPSON",
"first_name": "JODIE",
"middle_name": "MARIE",
"name_prefix": "Miss",
"credential": "OTR/L",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2013-03-08",
"last_updated": "2013-03-08",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "IL",
"license": "056.009860",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Chicago, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 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.