Jeanie Joe-Black, COTA

Primary specialty

Occupational Therapy AssistantTaxonomy code 224Z00000X

License

208845 Issued in TX

Practice address

3640 Hampton Dr
Missouri City, TX 77459-3016

Phone

(281) 778-5144

NPI assigned

Aug 15, 2018

Last updated

Aug 15, 2018By the provider in NPPES

Sex

Female

Sole proprietor

No

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

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": "1534291200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1534291200000",
    "number": "1861972275",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23623 CERTOSA DR",
            "city": "RICHMOND",
            "state": "TX",
            "postal_code": "774065485"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3640 HAMPTON DR",
            "city": "MISSOURI CITY",
            "state": "TX",
            "postal_code": "774593016",
            "telephone_number": "281-778-5144"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOE-BLACK",
        "first_name": "JEANIE",
        "credential": "COTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-08-15",
        "last_updated": "2018-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "TX",
            "license": "208845",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Occupational Therapy Assistant in Missouri City, TX
• Providers in Missouri City, TX by specialty
• Occupational Therapy Assistant in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2018; 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.