Active NPI
Jasmine Chastity Proctor, OTR/L
- Occupational Therapist
- Hazlehurst, MS
National Provider Identifier
1780388488
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 4008
- Practice address
- 27910 Ms-18
Hazlehurst, MS 39083 - Phone
- (601) 574-7388
- Fax
- (601) 894-3676
- NPI assigned
- Mar 28, 2023
- 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 | 4008 | MS | Primary |
Addresses
Primary practice location
27910 Ms-18
Hazlehurst, MS 39083
Mailing address
4050 Warner Dr
Brandon, MS 39042-8537
Phone (601) 941-9636
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 |
|---|---|---|---|
| 4008 | MS | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1679961600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1679961600000",
"number": "1780388488",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4050 WARNER DR",
"city": "BRANDON",
"state": "MS",
"postal_code": "390428537",
"telephone_number": "601-941-9636"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "27910 MS-18",
"city": "HAZLEHURST",
"state": "MS",
"postal_code": "39083",
"telephone_number": "601-574-7388",
"fax_number": "601-894-3676"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PROCTOR",
"first_name": "JASMINE",
"middle_name": "CHASTITY",
"name_prefix": "Ms.",
"credential": "OTR/L",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-03-28",
"last_updated": "2023-03-28",
"certification_date": "2023-03-23",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "MS",
"license": "4008",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Hazlehurst, MS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.