Individual provider Active NPI

Jessica H Holmes, OTR

  • Occupational Therapist
  • Milwaukee, WI
National Provider Identifier
1790222099
Registry record updated Jan 24, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
5854-26 Issued in WI
Practice address
3216 W Highland Blvd
(414) 344-6515
Milwaukee, WI 53208-3252
Phone
(414) 344-6515
NPI assigned
Jan 24, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 24, 2017

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 5854-26 WI Primary

Addresses

Primary practice location

3216 W Highland Blvd
(414) 344-6515
Milwaukee, WI 53208-3252

Mailing address

170 W Rainbow Ridge Dr
411
Oak Creek, WI 53154-2961
Phone (414) 202-5251

Other identifiers 1

IdentifierTypeStateIssuer
1740689710MedicaidWI

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
5854-26WIMDOccupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1485216000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1485216000000",
    "number": "1790222099",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "170 W RAINBOW RIDGE DR",
            "address_2": "411",
            "city": "OAK CREEK",
            "state": "WI",
            "postal_code": "531542961",
            "telephone_number": "414-202-5251"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3216 W HIGHLAND BLVD",
            "address_2": "(414) 344-6515",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532083252",
            "telephone_number": "414-344-6515"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLMES",
        "first_name": "JESSICA",
        "middle_name": "H",
        "name_prefix": "Mrs.",
        "credential": "OTR",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-01-24",
        "last_updated": "2017-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "WI",
            "license": "5854-26",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1740689710",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Milwaukee, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2017; 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.