Betty Christina Jaques, OTRL

Individual provider Active NPI Occupational Therapist · Blackfoot, ID

NPI 1811054265 · NPPES record last updated Sep 11, 2025

Key facts

NPI
1811054265
Entity type
Individual (NPI type 1)
Primary specialty
Occupational Therapist 225X00000X
License
OT-232 (ID)
Practice address
7 N 600 W
Blackfoot, ID 83221-5533
Phone
(208) 684-9812
NPI assigned
Jan 3, 2007
Sex
Female
Sole proprietor
Yes

Organizations & group practices 3

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.

Medicare Care Compare profile

Specialty
Occupational Therapist in Private Practice
Education
Other, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

7 N 600
Blackfoot, ID 83221-5533
Phone (208) 782-2267

Medicare participation

Medicare fee-for-service enrollment
Enrolled in ID

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20080306000694 ID Practitioner - Occupational Therapist in Private Practice 2264517895 Reassigns benefits to 1 organization

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
OT-232IDMDPediatric Occupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Camp Hippo Pediatric Therapy LLC Occupational Therapist Current
since Jan 1, 2009
Accepting new patients
Cruz Therapy Services Current Accepting new patients
Camp Hippo Pediatric Therapy LLC. Current
since Sep 7, 2009
Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X OT-232 ID Yes
Pediatric Occupational Therapist 225XP0200X OT-232 ID

Addresses

Primary practice location

7 N 600 W
Blackfoot, ID 83221-5533

Mailing address

7 N 600 W
Blackfoot, ID 83221-5533
Phone (208) 684-9812

Other providers in Blackfoot, ID

All providers in Blackfoot, ID · Occupational Therapist in Idaho

Sources for this page

Verify at the official NPI Registry.