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Deactivated NPI 1962684548 Deactivated / Inactive NPI Female Practitioner

Agatha M. Jackson

Occupational Therapist • Lamar, CO

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Notice of NPI Deactivation & Inactive Practice Status

According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Agatha Jackson has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date December 05, 2007
NPI Deactivation Date August 07, 2017
Total Practice Duration ~10 Years of Practice (2007 – 2017)

Professional Overview & Biography Verified Profile Summary

Agatha Jackson was a registered Occupational Therapist practicing in Lamar, CO. Throughout an active medical career spanning 10 years, Agatha Jackson provided care at the practice location at 205 S 10TH ST until profile deactivation on 2017-08-07.

Practice Location & Contact Primary Location

Practice Address

205 S 10th St

Lamar, CO 810522622

Telephone 7193363434
Fax 7193368770
Associated Practice Facility / Clinic
🏢 Juniper Haven, Lp Facility NPI 1215935424

Specialty Benchmarks & Practice Insights

Comparative analytics for Occupational Therapist in Lamar, CO

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 16.3 Yrs
Regional Practice Density
3 Specialists

Practicing in Lamar, CO (2877 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

Occupational Therapist Primary Specialty

NUCC Taxonomy Code: 225X00000X

An occupational therapist is a person who has graduated from an entry-level occupational therapy program accredited by the Accreditation Council for Occupational Therapy Education (ACOTE) or predecessor organizations, or approved by the World Federation of Occupational Therapists (WFOT), or an equivalent international occupational therapy education program; has successfully completed a period of supervised fieldwork experience required by the occupational therapy program; has passed a nationally recognized entry-level examination for occupational therapists, and fulfills state requirements for licensure, certification, or registration. An occupational therapist provides interventions based on evaluation and which emphasize the therapeutic use of everyday life activities (i.e., occupations) with individuals or groups for the purpose of facilitating participation in roles and situations and in home, school, workplace, community and other settings. Occupational therapy services are provided for the purpose of promoting health and wellness and are provided to those who have or are at risk for developing an illness, injury, disease, disorder, condition, impairment, disability, activity limitation, or participation restriction. Occupational therapists address the physical, cognitive, psychosocial, sensory, and other aspects of occupational performance in a variety of contexts to support engagement in everyday life activities that affect health, well-being, and quality of life.

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

7 Historical Events
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NPI Profile Deactivated August 07, 2017

Record deactivated on August 07, 2017

NPI Profile Active December 05, 2007

NPI status registered as active in NPPES database

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Updated Practice Location December 05, 2007

Registered at 205 S 10TH ST, LAMAR, CO 810522622 (Tel: 7193363434)

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Updated Business Mailing Address December 05, 2007

Registered at 101 FORDHAM CIR, PUEBLO, CO 810051647

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Provider Name / Credentials Updated December 05, 2007

Recorded as AGATHA JACKSON

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Medical Taxonomy / Specialty Registered (Primary Specialty) December 05, 2007

Occupational Therapist

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Initial NPI Registration & Enumeration December 05, 2007

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1962684548
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: December 05, 2007
Last Update: December 05, 2007
Deactivation Date: August 07, 2017

Mailing Address

101 Fordham Cir

Pueblo, CO 810051647

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.