NPIMap

Individual provider Active NPI

Jessica Horan

  • Occupational Therapist
  • Providence, RI
National Provider Identifier
1851689301
Registry record updated May 30, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
OT00168-G Issued in RI
Practice address
1000 Eddy Street
Providence, RI 02905
Phone
(401) 481-0823
NPI assigned
Jul 19, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 30, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X OT00168-G RI Primary

Addresses

Primary practice location

1000 Eddy Street
Providence, RI 02905

Mailing address

121 Meadowlark Dr
Seekonk, MA 02771-2713
Phone (508) 272-4980

Other identifiers 5

IdentifierTypeStateIssuer
ES01788MedicaidRI
412296OtherRIEI BCHIP
292177OtherRIEI BCROSS
6400144OtherRIEI UNITED
2092OtherRIEI NHPRC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240627003601 WA Practitioner - Physical Therapist in Private Practice 9335683671 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OT00168-GRIMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Meeting Street Center Past Accepting new patients
Meeting Street Center Past Accepting new patients
Public Hospital District No 4 King County Washington Past Accepting new patients

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.

NPI Registry JSON

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

{
    "created_epoch": "1311033600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1401408000000",
    "number": "1851689301",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "121 MEADOWLARK DR",
            "city": "SEEKONK",
            "state": "MA",
            "postal_code": "027712713",
            "telephone_number": "508-272-4980"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 EDDY STREET",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "02905",
            "telephone_number": "401-481-0823"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HORAN",
        "first_name": "JESSICA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-07-19",
        "last_updated": "2014-05-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "RI",
            "license": "OT00168-G",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "ES01788",
            "state": "RI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EI BCHIP",
            "identifier": "412296",
            "state": "RI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EI BCROSS",
            "identifier": "292177",
            "state": "RI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EI UNITED",
            "identifier": "6400144",
            "state": "RI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EI NHPRC",
            "identifier": "2092",
            "state": "RI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Providence, RI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 30, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.