James Alan Jackimowicz, OT

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

8388-26 Issued in WI

Practice address

3263 Eaton Rd
Green Bay, WI 54311-6830

Phone

(920) 433-6700

Fax

(920) 433-6719

NPI assigned

Oct 10, 2023

Sex

Male

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1696896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698105600000",
    "number": "1982485595",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 22487",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543052487",
            "telephone_number": "920-445-7210",
            "fax_number": "920-445-7289"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3263 EATON RD",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543116830",
            "telephone_number": "920-433-6700",
            "fax_number": "920-433-6719"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKIMOWICZ",
        "first_name": "JAMES",
        "middle_name": "ALAN",
        "credential": "OT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-10-10",
        "last_updated": "2023-10-24",
        "certification_date": "2023-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "WI",
            "license": "8388-26",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michael W. Itagaki, MD
• Janelle Michelle Iwen, PHARMD
• Hussam Jaber
• Sarah Lynn Jabo, PA-C
• Jackie Nitschke Center, Inc.
• Lorraine Helena Mary Jackson, MD
• Peter Allen Jackson, PHARMD
• Shawn E Jackson, P.T.
• Andrew Jacob, DDS
• Jacob'S Well Counseling Center Inc

• Occupational Therapist in Green Bay, WI
• Providers in Green Bay, WI by specialty
• Occupational Therapist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.