Individual provider Active NPI

Jessica Morgan Witt, COTA-L

  • Occupational Therapy Assistant
  • Bristol, VA
National Provider Identifier
1861956864
Registry record updated Jan 24, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Therapy AssistantTaxonomy code 224Z00000X
License
0131002111 Issued in VA
Practice address
245 North St
Bristol, VA 24201-3274
Phone
(276) 669-4711
NPI assigned
Jan 24, 2019
Last updated
Jan 24, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 24, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy Assistant 224Z00000X 0131002111 VA Primary

Addresses

Primary practice location

245 North St
Bristol, VA 24201-3274

Mailing address

3066 Upper Copper Creek Rd
Castlewood, VA 24224-6275

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
0131002111VAMDOccupational Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1548288000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1548288000000",
    "number": "1861956864",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3066 UPPER COPPER CREEK RD",
            "city": "CASTLEWOOD",
            "state": "VA",
            "postal_code": "242246275"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "245 NORTH ST",
            "city": "BRISTOL",
            "state": "VA",
            "postal_code": "242013274",
            "telephone_number": "276-669-4711"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WITT",
        "first_name": "JESSICA",
        "middle_name": "MORGAN",
        "credential": "COTA-L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-01-24",
        "last_updated": "2019-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "VA",
            "license": "0131002111",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bristol, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2019; 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.