Individual provider Active NPI

Gessica Dian Stovall, OTD

  • Occupational Therapist
  • Murray, UT
National Provider Identifier
1891335279
Registry record updated Jan 13, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
11511725-4201 Issued in UT
Practice address
5121 S Cottonwood St
Murray, UT 84107-5701
Phone
(504) 234-0241
NPI assigned
Jan 13, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 13, 2020

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

Specialties & licenses 10

Specialty (taxonomy)CodeLicenseStatePrimary
Environmental Modification Occupational Therapist 225XE0001X 11511725-4201 UT
Ergonomics Occupational Therapist 225XE1200X 11511725-4201 UT
Gerontology Occupational Therapist 225XG0600X 11511725-4201 UT
Low Vision Occupational Therapist 225XL0004X 11511725-4201 UT
Mental Health Occupational Therapist 225XM0800X 11511725-4201 UT
Neurorehabilitation Occupational Therapist 225XN1300X 11511725-4201 UT
Physical Rehabilitation Occupational Therapist 225XP0019X 11511725-4201 UT
Pediatric Occupational Therapist 225XP0200X 11511725-4201 UT
Driving and Community Mobility Occupational Therapist 225XR0403X 11511725-4201 UT
Occupational Therapist 225X00000X 11511725-4201 UT Primary

Addresses

Primary practice location

5121 S Cottonwood St
Murray, UT 84107-5701

Mailing address

9644 S Kalina Way
Apt 207
Sandy, UT 84092-1237
Phone (504) 234-0241

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address Gessica.Stovall@imail.org

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
11511725-4201UTMDGerontology Occupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1578873600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1578873600000",
    "number": "1891335279",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9644 S KALINA WAY",
            "address_2": "APT 207",
            "city": "SANDY",
            "state": "UT",
            "postal_code": "840921237",
            "telephone_number": "504-234-0241"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5121 S COTTONWOOD ST",
            "city": "MURRAY",
            "state": "UT",
            "postal_code": "841075701",
            "telephone_number": "504-234-0241"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STOVALL",
        "first_name": "GESSICA",
        "middle_name": "DIAN",
        "name_prefix": "Dr.",
        "credential": "OTD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-01-13",
        "last_updated": "2020-01-13",
        "certification_date": "2020-01-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XE0001X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Environmental Modification",
            "state": "UT",
            "license": "11511725-4201",
            "primary": false
        },
        {
            "code": "225XE1200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Ergonomics",
            "state": "UT",
            "license": "11511725-4201",
            "primary": false
        },
        {
            "code": "225XG0600X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Gerontology",
            "state": "UT",
            "license": "11511725-4201",
            "primary": false
        },
        {
            "code": "225XL0004X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Low Vision",
            "state": "UT",
            "license": "11511725-4201",
            "primary": false
        },
        {
            "code": "225XM0800X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Mental Health",
            "state": "UT",
            "license": "11511725-4201",
            "primary": false
        },
        {
            "code": "225XN1300X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Neurorehabilitation",
            "state": "UT",
            "license": "11511725-4201",
            "primary": false
        },
        {
            "code": "225XP0019X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Physical Rehabilitation",
            "state": "UT",
            "license": "11511725-4201",
            "primary": false
        },
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "UT",
            "license": "11511725-4201",
            "primary": false
        },
        {
            "code": "225XR0403X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Driving and Community Mobility",
            "state": "UT",
            "license": "11511725-4201",
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "UT",
            "license": "11511725-4201",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Gessica.Stovall@imail.org",
            "affiliation": "N",
            "address_1": "5121 S Cottonwood St",
            "city": "Murray",
            "state": "UT",
            "country_code": "US",
            "postal_code": "841075701",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Murray, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2020; 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.