Individual provider Active NPI

Janelle Jacobson, COTA/L

  • Occupational Therapy Assistant
  • Inver Grove Heights, MN
National Provider Identifier
1982840682
Registry record updated Dec 30, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Therapy AssistantTaxonomy code 224Z00000X
License
201297 Issued in MN
Practice address
5695 Blaine Ave
Inver Grove Heights, MN 55076-1226
Phone
(651) 554-9940
Fax
(651) 554-9941
NPI assigned
Dec 30, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 30, 2008

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy Assistant 224Z00000X 201297 MN Primary

Addresses

Primary practice location

5695 Blaine Ave
Inver Grove Heights, MN 55076-1226

Mailing address

5695 Blaine Ave
Inver Grove Heights, MN 55076-1226
Phone (651) 554-9940

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
201297MNMDOccupational Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Step Ahead Pediatric Rehab Inc. Occupational Therapy Assistant Past Accepting new patients
Step Ahead Corporation Occupational Therapy Assistant Past Accepting new patients

Organizations & group practices 2

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": "1230595200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1230595200000",
    "number": "1982840682",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5695 BLAINE AVE",
            "city": "INVER GROVE HEIGHTS",
            "state": "MN",
            "postal_code": "550761226",
            "telephone_number": "651-554-9940",
            "fax_number": "651-554-9941"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5695 BLAINE AVE",
            "city": "INVER GROVE HEIGHTS",
            "state": "MN",
            "postal_code": "550761226",
            "telephone_number": "651-554-9940",
            "fax_number": "651-554-9941"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACOBSON",
        "first_name": "JANELLE",
        "credential": "COTA/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-12-30",
        "last_updated": "2008-12-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "MN",
            "license": "201297",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Inver Grove Heights, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 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.

Verify at the official NPI Registry.