Active NPI
Mildred Irene Jones-Keller, O.T.
- Occupational Therapist
- Atwater, CA
National Provider Identifier
1972780716
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- OT6260
- Practice address
- 1675 Shaffer Rd
Atwater, CA 95301-4456 - Phone
- (209) 357-3420
- Fax
- (209) 357-0904
- NPI assigned
- Jan 23, 2008
- Last updated
- Jan 23, 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 | OT6260 | CA | Primary |
Addresses
Primary practice location
1675 Shaffer Rd
Atwater, CA 95301-4456
Mailing address
1685 Shaffer Rd
Atwater, CA 95301-4456
Phone (209) 357-3420
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 555244 | Other | CA | MEDICARE PROVIDER NUMBER |
| LTC55244H | Medicaid | CA |
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 |
|---|---|---|---|
| OT6260 | CA | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1201046400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1201046400000",
"number": "1972780716",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1685 SHAFFER RD",
"city": "ATWATER",
"state": "CA",
"postal_code": "953014456",
"telephone_number": "209-357-3420",
"fax_number": "209-357-0904"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1675 SHAFFER RD",
"city": "ATWATER",
"state": "CA",
"postal_code": "953014456",
"telephone_number": "209-357-3420",
"fax_number": "209-357-0904"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JONES-KELLER",
"first_name": "MILDRED",
"middle_name": "IRENE",
"credential": "O.T.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-01-23",
"last_updated": "2008-01-23",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "CA",
"license": "OT6260",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE PROVIDER NUMBER",
"identifier": "555244",
"state": "CA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "LTC55244H",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Atwater, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 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.