Racquel Gaddis

Primary specialty

Occupational Therapy AssistantTaxonomy code 224Z00000X

License

OTA-2366 Issued in MS

Practice address

224 Silver LK
Pearl, MS 39208-5079

Phone

(601) 941-8323

NPI assigned

Feb 12, 2024

Last updated

Feb 12, 2024By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1707696000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707696000000",
    "number": "1811751613",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "224 SILVER LK",
            "city": "PEARL",
            "state": "MS",
            "postal_code": "392085079",
            "telephone_number": "601-941-8323"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "224 SILVER LK",
            "city": "PEARL",
            "state": "MS",
            "postal_code": "392085079",
            "telephone_number": "601-941-8323"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GADDIS",
        "first_name": "RACQUEL",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-02-12",
        "last_updated": "2024-02-12",
        "certification_date": "2024-02-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "MS",
            "license": "OTA-2366",
            "primary": true
        },
        {
            "code": "224ZF0002X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant, Feeding, Eating & Swallowing",
            "state": "MS",
            "license": "OTA-2366",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Occupational Therapy Assistant in Pearl, MS
• Providers in Pearl, MS by specialty
• Occupational Therapy Assistant in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2024; 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.