Individual provider Active NPI

Jessica A Vandegrift, OTR/L

  • Occupational Therapist
  • Fairhope, AL
National Provider Identifier
1780166264
Registry record updated Aug 31, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
2713 Issued in AL
Practice address
10675 County Road 24
Fairhope, AL 36532-5058
Phone
(251) 928-3640
Fax
(251) 928-3640
NPI assigned
Aug 31, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 31, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 2713 AL Primary

Addresses

Primary practice location

10675 County Road 24
Fairhope, AL 36532-5058

Mailing address

10675 County Road 24
Fairhope, AL 36532-5058
Phone (251) 928-3640

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

LicenseStateTypeSpecialty
2713ALMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Hand in Hand Therapy & Tutoring Occupational Therapist Past Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1535673600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1535673600000",
    "number": "1780166264",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10675 COUNTY ROAD 24",
            "city": "FAIRHOPE",
            "state": "AL",
            "postal_code": "365325058",
            "telephone_number": "251-928-3640",
            "fax_number": "251-928-3640"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10675 COUNTY ROAD 24",
            "city": "FAIRHOPE",
            "state": "AL",
            "postal_code": "365325058",
            "telephone_number": "251-928-3640",
            "fax_number": "251-928-3640"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANDEGRIFT",
        "first_name": "JESSICA",
        "middle_name": "A",
        "credential": "OTR/L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-08-31",
        "last_updated": "2018-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "AL",
            "license": "2713",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairhope, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2018; 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.