Individual provider Active NPI

Jodi Anne Dresmich, COTA/L

  • Occupational Therapy Assistant
  • Myrtle Beach, SC
National Provider Identifier
1780872523
Registry record updated Oct 5, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Therapy AssistantTaxonomy code 224Z00000X
License
2652 Issued in SC
Practice address
614 Woodbine CT
Myrtle Beach, SC 29579-1747
Phone
(843) 497-3000
NPI assigned
Oct 5, 2007
Last updated
Oct 5, 2007By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 5, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy Assistant 224Z00000X 2652 SC Primary

Addresses

Primary practice location

614 Woodbine CT
Myrtle Beach, SC 29579-1747

Mailing address

614 Woodbine CT
Myrtle Beach, SC 29579-1747

Other identifiers 1

IdentifierTypeStateIssuer
2652OtherSCOT 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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
2652SCMDOccupational Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1191542400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1191542400000",
    "number": "1780872523",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "614 WOODBINE CT",
            "city": "MYRTLE BEACH",
            "state": "SC",
            "postal_code": "295791747"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "614 WOODBINE CT",
            "city": "MYRTLE BEACH",
            "state": "SC",
            "postal_code": "295791747",
            "telephone_number": "843-497-3000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DRESMICH",
        "first_name": "JODI",
        "middle_name": "ANNE",
        "name_prefix": "Ms.",
        "credential": "COTA/L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-10-05",
        "last_updated": "2007-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "SC",
            "license": "2652",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OT LICENSE",
            "identifier": "2652",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Myrtle Beach, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2007; 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.