Individual provider Active NPI

Jodie Jean McCutcheon

  • Occupational Therapist
  • Manchester, NH
National Provider Identifier
1861921777
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
17508 Issued in CA
Practice address
3000 Goffs Falls Rd Ste 101
Manchester, NH 03103-6109
Phone
(800) 995-2673
Fax
(888) 979-6551
NPI assigned
Jun 6, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 116682 TX
Occupational Therapist 225X00000X 17508 CA Primary

Addresses

Primary practice location

3000 Goffs Falls Rd Ste 101
Manchester, NH 03103-6109

Mailing address

3000 Goffs Falls Rd Ste 101
Manchester, NH 03103-6109
Phone (800) 995-2673

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230629002380 TX Practitioner - Occupational Therapist in Private Practice 1355700964 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

8100 Precinct Line Rd
Colleyville, TX 76034-7674
Phone (682) 244-4317

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
116682TXMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Healthpro Heritage Rehab & Fitness, LLC Occupational Therapist CurrentSince May 15, 2023 Accepting new patients
Aegis Group Practice LLC Occupational Therapist CurrentSince Sep 27, 2023 Accepting new patients
Aegis Group Practice LLC Occupational Therapist CurrentSince Sep 27, 2023 Accepting new patients
Aegis Group Practice LLC Occupational Therapist Current Accepting new patients
Healthpro Heritage Rehab & Fitness, LLC Occupational Therapist CurrentSince May 15, 2023 Accepting new patients

Locations

1860 N Cooper St
Arlington, TX 76011
Phone (469) 575-3312

8100 Precinct Line Rd
Colleyville, TX 76034
Phone (682) 244-4317

800 Whitley Rd
Keller, TX 76248
Phone (817) 357-7181

265 Plateau Dr
McKinney, TX 75069
Phone (512) 277-6405

Organizations & group practices 5

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": "1496707200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1861921777",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3000 GOFFS FALLS RD STE 101",
            "city": "MANCHESTER",
            "state": "NH",
            "postal_code": "031036109",
            "telephone_number": "800-995-2673",
            "fax_number": "888-979-6551"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3000 GOFFS FALLS RD STE 101",
            "city": "MANCHESTER",
            "state": "NH",
            "postal_code": "031036109",
            "telephone_number": "800-995-2673",
            "fax_number": "888-979-6551"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCUTCHEON",
        "first_name": "JODIE",
        "middle_name": "JEAN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-06-06",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "TX",
            "license": "116682",
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "CA",
            "license": "17508",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Manchester, NH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.