Jamie Lee Guangco, OTD/OTR

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

31006701A Issued in IN

Practice address

705 N Meridian St
Greentown, IN 46936-1246

Phone

(765) 628-3377

NPI assigned

Jan 23, 2019

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

Enrolled in IN

Enrollment records 1

Specialty

Occupational Therapist in Private Practice

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Healthpro Heritage Rehab and Fitness LLCGroup PAC ID 6507832573, 976 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Healthpro Heritage Rehab & Fitness, LLC

  • Physical Therapist
  • Merrillville, IN
  • NPI 1053833657
  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1548201600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1548201600000",
    "number": "1922562966",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2804 TUMBLEWEED DR",
            "city": "KOKOMO",
            "state": "IN",
            "postal_code": "469014090"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "705 N MERIDIAN ST",
            "city": "GREENTOWN",
            "state": "IN",
            "postal_code": "469361246",
            "telephone_number": "765-628-3377"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUANGCO",
        "first_name": "JAMIE",
        "middle_name": "LEE",
        "name_prefix": "Dr.",
        "credential": "OTD/OTR",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-01-23",
        "last_updated": "2019-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "IN",
            "license": "31006701A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ronald Joseph Essington, PHARM D
• Brock Allen Ford, PT,DPT
• Marlayna Marie Gagnon, C.O.T.A.
• Ishan Gohil, MD
• Greentown Volunteer Fire Company
• Alyssa Harvey
• Margaret Hatteberg, BCBA
• Madison Haupert
• Haven Home Health Care LLC
• Haven Homecare LLC

• Occupational Therapist in Greentown, IN
• Providers in Greentown, IN by specialty
• Occupational Therapist in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2019; 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.