Jaclyn Roepcke, MS OTRL

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

5201009265 Issued in MI

Practice address

2814 Woodcliff Cir SE
Grand Rapids, MI 49506

Phone

(855) 583-2672

NPI assigned

Nov 19, 2015

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Jaclyn Main Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

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

{
    "created_epoch": "1447891200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1562112000000",
    "number": "1801260492",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6987 SCOTT LAKE TRL NE",
            "city": "COMSTOCK PARK",
            "state": "MI",
            "postal_code": "493219603"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2814 WOODCLIFF CIR SE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "49506",
            "telephone_number": "855-583-2672"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4554 E. Main St",
            "address_purpose": "LOCATION",
            "city": "Fremont",
            "state": "MI",
            "postal_code": "494128721",
            "country_code": "US",
            "telephone_number": "231-924-1013",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROEPCKE",
        "first_name": "JACLYN",
        "credential": "MS OTRL",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-11-19",
        "last_updated": "2019-07-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "MI",
            "license": "5201009265",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JACLYN",
            "last_name": "MAIN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Kylie Jo Roel, LMSW
• Leandra Faith Roelker, MD
• Brian Alan Roelof, M.D.
• Justin Dean Roelofs, FNP-C
• Patricia Eggers Roels, D.D.S
• Sasha J Roettger
• Robert Scott Rogalke, PHARMACIST
• Peggy Warren Rogalski
• Katelyn Rogan
• Abby Jayne Rogers, PA-C

• Occupational Therapist in Grand Rapids, MI
• Providers in Grand Rapids, MI by specialty
• Occupational Therapist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 3, 2019; 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.