Individual provider Active NPI

Jessica Marcus, MSOT, OTR/L

  • Pediatric Occupational Therapist
  • Monroe, NC
National Provider Identifier
1992384697
Registry record updated Apr 7, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Occupational TherapistTaxonomy code 225XP0200X
License
13912 Issued in NC
Practice address
1902 W Roosevelt Blvd Ste C
Monroe, NC 28110-3788
Phone
(980) 422-5588
NPI assigned
Apr 7, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 7, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Occupational Therapist 225XP0200X 13912 NC Primary

Addresses

Primary practice location

1902 W Roosevelt Blvd Ste C
Monroe, NC 28110-3788

Mailing address

1219 Gramercy Dr
Indian Trail, NC 28079-0377
Phone (704) 962-1061

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
13912NCMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Faith Works Therapy Pediatrics CurrentSince Apr 11, 2021 Accepting new patients
Speech Tactics, PC PastSince Apr 11, 2021 Accepting new patients
Lifetouchtherapy, PLLC Past Accepting new patients

Organizations & group practices 3

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": "1617753600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617753600000",
    "number": "1992384697",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1219 GRAMERCY DR",
            "city": "INDIAN TRAIL",
            "state": "NC",
            "postal_code": "280790377",
            "telephone_number": "704-962-1061"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1902 W ROOSEVELT BLVD STE C",
            "city": "MONROE",
            "state": "NC",
            "postal_code": "281103788",
            "telephone_number": "980-422-5588"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARCUS",
        "first_name": "JESSICA",
        "credential": "MSOT, OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-04-07",
        "last_updated": "2021-04-07",
        "certification_date": "2021-04-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "NC",
            "license": "13912",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Monroe, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 7, 2021; 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.