Gianna Marie Jacullo, OTR/L

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

7159 Issued in SC

Practice address

1110 Heather Glen Blvd
Little River, SC 29566-5947

Phone

(631) 708-7913

NPI assigned

Apr 20, 2024

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in SC

Enrollment records 1

Specialty

Occupational Therapist in Private Practice

Education

Other, 2024

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Legacy Healthcare Services IncGroup PAC ID 2163339722, 3,431 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Legacy Healthcare Services Inc

  • Physical Therapist
  • Little River, SC
  • NPI 1366063000

  Occupational Therapist

  Medicare reassignment Care Compare group NPD
• Legacy Healthcare Services Inc

  • Physical Therapist
  • Cary, NC
  • NPI 1225879489

  Occupational Therapist

  NPD

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

{
    "created_epoch": "1713571200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1763424000000",
    "number": "1841045119",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1110 HEATHER GLEN BLVD",
            "city": "LITTLE RIVER",
            "state": "SC",
            "postal_code": "295665947",
            "telephone_number": "631-708-7913"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1110 HEATHER GLEN BLVD",
            "city": "LITTLE RIVER",
            "state": "SC",
            "postal_code": "295665947",
            "telephone_number": "631-708-7913"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACULLO",
        "first_name": "GIANNA",
        "middle_name": "MARIE",
        "credential": "OTR/L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-04-20",
        "last_updated": "2025-11-18",
        "certification_date": "2025-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "SC",
            "license": "7159",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shannon R Hussey, FNP
• Donny Vu Huynh, M.D.
• Gillian Marie Hyde, PA-C
• Elaian Berneshia Hypolite
• Brenden Jackson
• Leah Jarrett, OTR/L
• Jazz & Coco LLC (Jim Bennett Counselor)
• Autumn McKenzie Johnson, MAT, LAT, ATC
• David M. Johnson, MD
• Joined Together Marriage& Family LLC

• Occupational Therapist in Little River, SC
• Providers in Little River, SC by specialty
• Occupational Therapist in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.