Active NPI
Jaclyn Solomon, COTA/L
- Occupational Therapy Assistant
- Morehead City, NC
National Provider Identifier
1801213616
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapy Assistant
- License
- 9132
- Practice address
- 4218-M Arendell St
Morehead City, NC 28557 - Phone
- (252) 808-3100
- NPI assigned
- Mar 19, 2014
- 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 Therapy Assistant | 224Z00000X | 9132 | NC | Primary |
Addresses
Primary practice location
4218-M Arendell St
Morehead City, NC 28557
Mailing address
4218-M Arendell St
Morehead City, NC 28557
Phone (252) 808-3100
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 9132 | Other | NC | STATE 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
| License | State | Type | Specialty |
|---|---|---|---|
| 9132 | NC | MD | Geriatric Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1395187200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1395187200000",
"number": "1801213616",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4218-M ARENDELL ST",
"city": "MOREHEAD CITY",
"state": "NC",
"postal_code": "28557",
"telephone_number": "252-808-3100"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4218-M ARENDELL ST",
"city": "MOREHEAD CITY",
"state": "NC",
"postal_code": "28557",
"telephone_number": "252-808-3100"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SOLOMON",
"first_name": "JACLYN",
"credential": "COTA/L",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-03-19",
"last_updated": "2014-03-19",
"status": "A"
},
"taxonomies": [
{
"code": "224Z00000X",
"taxonomy_group": "",
"desc": "Occupational Therapy Assistant",
"state": "NC",
"license": "9132",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STATE LICENSE",
"identifier": "9132",
"state": "NC"
}
],
"endpoints": [],
"other_names": []
}Other providers in Morehead City, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.