Active NPI
Carissa Jones, OTR/L
- Occupational Therapist
- Beavercreek, OH
National Provider Identifier
1962076323
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- OT011529
- Practice address
- 3817 Colonel Glenn Hwy
Beavercreek, OH 45324-2268 - Phone
- (513) 755-6600
- NPI assigned
- May 19, 2021
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | OT556 | AL | |
| Occupational Therapist | 225X00000X | OT011529 | OH | Primary |
Addresses
Primary practice location
3817 Colonel Glenn Hwy
Beavercreek, OH 45324-2268
Mailing address
PO Box 411169
Boston, MA 02241-2515
Phone (914) 294-4050
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| OT556 | AL | MD | Occupational Therapist |
| OT011529 | OH | MD | Occupational Therapist |
| 5566 | AL | MD | Speech-Language Pathologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Abc Pediatric Therapy LLC | Occupational Therapist | Past | Accepting new patients |
Organizations & group practices 1
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1621382400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1640131200000",
"number": "1962076323",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 411169",
"city": "BOSTON",
"state": "MA",
"postal_code": "022412515",
"telephone_number": "914-294-4050"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3817 COLONEL GLENN HWY",
"city": "BEAVERCREEK",
"state": "OH",
"postal_code": "453242268",
"telephone_number": "513-755-6600"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JONES",
"first_name": "CARISSA",
"credential": "OTR/L",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-05-19",
"last_updated": "2021-12-22",
"certification_date": "2021-12-22",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "AL",
"license": "OT556",
"primary": false
},
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "OH",
"license": "OT011529",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Beavercreek, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 22, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.