Jessica Provost, OTD, OTR/L

Primary specialty

Pediatric Occupational TherapistTaxonomy code 225XP0200X

Practice address

10095 Brick Church Rd
Cambridge, OH 43725-8550

Phone

(740) 439-8977

NPI assigned

Mar 23, 2022

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Interoperability endpoints

• Direct secure messaging: jcprovost@seormc.org

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

{
    "created_epoch": "1647993600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1647993600000",
    "number": "1992454128",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2441 OHIO AVE",
            "city": "CAMBRIDGE",
            "state": "OH",
            "postal_code": "437259122"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10095 BRICK CHURCH RD",
            "city": "CAMBRIDGE",
            "state": "OH",
            "postal_code": "437258550",
            "telephone_number": "740-439-8977"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PROVOST",
        "first_name": "JESSICA",
        "credential": "OTD, OTR/L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-03-23",
        "last_updated": "2022-03-23",
        "certification_date": "2022-03-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OCCUPATIONAL THERAPIST LICENSE",
            "identifier": "OT011325",
            "state": null
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Jcprovost@seormc.org",
            "affiliation": "N",
            "address_1": "10095 Brick Church Rd",
            "city": "Cambridge",
            "state": "OH",
            "country_code": "US",
            "postal_code": "437258550",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Carly Pratt
• Rosa L Price
• Wanda R Price
• Dominque Proctor
• Professionals PRN LLC
• Earnest Warren Lemar Pughsley Jr.
• Kylie Pyers
• Joshua D Quinn, BA, RA
• Lindsey N Ramage
• Billimagga V Rangaswamy, M.D.

• Pediatric Occupational Therapist in Cambridge, OH
• Providers in Cambridge, OH by specialty
• Pediatric Occupational Therapist in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 2022; 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.