Active NPI
Joan Lynne Jackson, OTR/L
- Occupational Therapist
- Sierra Vista, AZ
National Provider Identifier
1962665448
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- AA353292
- Practice address
- 660 S Coronado Dr
Sierra Vista, AZ 85635-3386 - Phone
- (520) 459-5900
- NPI assigned
- Jul 6, 2008
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | AA353292 | AZ | Primary |
Addresses
Primary practice location
660 S Coronado Dr
Sierra Vista, AZ 85635-3386
Mailing address
PO Box 55
Sierra Vista, AZ 85636-0055
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 |
|---|---|---|---|
| AA353292 | AZ | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1215302400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1215302400000",
"number": "1962665448",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 55",
"city": "SIERRA VISTA",
"state": "AZ",
"postal_code": "856360055"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "660 S CORONADO DR",
"city": "SIERRA VISTA",
"state": "AZ",
"postal_code": "856353386",
"telephone_number": "520-459-5900"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JACKSON",
"first_name": "JOAN",
"middle_name": "LYNNE",
"credential": "OTR/L",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-07-06",
"last_updated": "2008-07-06",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "AZ",
"license": "AA353292",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Sierra Vista, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 6, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.