Active NPI
Jacob Louis Estienne, MS, OTR/L
- Occupational Therapist
- Chesapeake, VA
National Provider Identifier
1912626938
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 0119008775
- Practice address
- 2248 Averill Dr
Chesapeake, VA 23323-6824 - Phone
- (540) 494-9676
- NPI assigned
- Aug 23, 2022
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 0119008775 | VA | Primary |
Addresses
Primary practice location
2248 Averill Dr
Chesapeake, VA 23323-6824
Mailing address
225 Cedar Rd
Chesapeake, VA 23322-5511
Phone (540) 494-9676
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
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0119008775 | VA | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1661212800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1661212800000",
"number": "1912626938",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "225 CEDAR RD",
"city": "CHESAPEAKE",
"state": "VA",
"postal_code": "233225511",
"telephone_number": "540-494-9676"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2248 AVERILL DR",
"city": "CHESAPEAKE",
"state": "VA",
"postal_code": "233236824",
"telephone_number": "540-494-9676"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ESTIENNE",
"first_name": "JACOB",
"middle_name": "LOUIS",
"credential": "MS, OTR/L",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2022-08-23",
"last_updated": "2022-08-23",
"certification_date": "2022-08-23",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "VA",
"license": "0119008775",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Chesapeake, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.