Jill T Fetrow, OCCUPATIONAL

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

1584 Issued in IA

Practice address

315 W 5TH St
Storm Lake, IA 50588-1743

Phone

(712) 732-7725

Fax

(712) 732-5153

NPI assigned

Feb 2, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Specialty

Occupational Therapist in Private Practice

Education

Other, 2003

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Sports Rehab and Professional Therapy Associates Inc

  dba Sports Rehab & Professional Therapy

  • Rehabilitation Clinic/Center
  • Storm Lake, IA
  • NPI 1033289749

  Occupational Therapist

  NPD
• Sports Rehab & Professional Therapy Associates

  • Customized Equipment (DME)
  • Storm Lake, IA
  • NPI 1285772970
  NPD (past)

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

{
    "created_epoch": "1170374400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1811035678",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "104 NW 8TH ST",
            "city": "POCAHONTAS",
            "state": "IA",
            "postal_code": "505741426",
            "telephone_number": "712-732-7725",
            "fax_number": "712-732-5153"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "315 W 5TH ST",
            "city": "STORM LAKE",
            "state": "IA",
            "postal_code": "505881743",
            "telephone_number": "712-732-7725",
            "fax_number": "712-732-5153"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FETROW",
        "first_name": "JILL",
        "middle_name": "T",
        "credential": "OCCUPATIONAL",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-02",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "IA",
            "license": "1584",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLMARK OF IOWA",
            "identifier": "37037",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• James Paul Faine, D.C.
• Family First Dental Associates of Primghar, P.C. (Family 1st Dental of Storm Lake)
• Garrett James Feddersen, D.O.
• Christine M Feltman, PHYSICAL THERAPIST
• Sarah Colleen Fennell
• FHC of Storm Lake Iowa Inc (Faith Hope & Charity)
• Pamela J Fieber, CNP
• Monica L Firme, CRNA
• Tiffany Flammang, C.O.T.A.
• Charles Richard Flickinger, DNP

• Occupational Therapist in Storm Lake, IA
• Providers in Storm Lake, IA by specialty
• Occupational Therapist in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.