Active NPI
Jessica C Lewis, OTR/L
- Occupational Therapist
- Grand Rapids, MI
National Provider Identifier
1962836536
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 60136462
- Practice address
- 235 Wealthy St SE
Grand Rapids, MI 49503-5247 - Phone
- (616) 840-8558
- NPI assigned
- Aug 30, 2013
- 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 5
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 5201009924 | ||
| Neurorehabilitation Occupational Therapist | 225XN1300X | 60136462 | WA | |
| Physical Rehabilitation Occupational Therapist | 225XP0019X | 60136462 | WA | |
| Driving and Community Mobility Occupational Therapist | 225XR0403X | 60136462 | WA | |
| Occupational Therapist | 225X00000X | 60136462 | WA | Primary |
Addresses
Primary practice location
235 Wealthy St SE
Grand Rapids, MI 49503-5247
Mailing address
1511 Hidden Valley Dr SE Apt 12
Kentwood, MI 49508-6487
Phone (319) 400-7343
Other practice location 1
1959 NE Pacific St
Seattle, WA 98195
Phone (206) 598-5357
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 |
|---|---|---|---|
| 60136462 | WA | MD | Physical Rehabilitation Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1377820800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1521244800000",
"number": "1962836536",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1511 HIDDEN VALLEY DR SE APT 12",
"city": "KENTWOOD",
"state": "MI",
"postal_code": "495086487",
"telephone_number": "319-400-7343"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "235 WEALTHY ST SE",
"city": "GRAND RAPIDS",
"state": "MI",
"postal_code": "495035247",
"telephone_number": "616-840-8558"
}
],
"practiceLocations": [
{
"address_1": "1959 NE Pacific St",
"address_purpose": "LOCATION",
"city": "Seattle",
"state": "WA",
"postal_code": "98195",
"country_code": "US",
"telephone_number": "206-598-5357",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "LEWIS",
"first_name": "JESSICA",
"middle_name": "C",
"credential": "OTR/L",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-08-30",
"last_updated": "2018-03-17",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": null,
"license": "5201009924",
"primary": false
},
{
"code": "225XN1300X",
"taxonomy_group": "",
"desc": "Occupational Therapist, Neurorehabilitation",
"state": "WA",
"license": "60136462",
"primary": false
},
{
"code": "225XP0019X",
"taxonomy_group": "",
"desc": "Occupational Therapist, Physical Rehabilitation",
"state": "WA",
"license": "60136462",
"primary": false
},
{
"code": "225XR0403X",
"taxonomy_group": "",
"desc": "Occupational Therapist, Driving and Community Mobility",
"state": "WA",
"license": "60136462",
"primary": false
},
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "WA",
"license": "60136462",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Grand Rapids, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.