IndividualActive
Jake Gibbons, OTA
NPI 1043488562 · Occupational Therapy Assistant · Fontanelle, IA
Provider details
- NPI number
- 1043488562
- Entity type
- Individual
- Primary specialty
- Occupational Therapy AssistantRespiratory, Developmental, Rehabilitative and Restorative Service Providers
- Credential
- OTA
- Sex
- Male
- Sole proprietor
- No
- License
- 00306 (IA)
Specialties & taxonomies
Respiratory, Developmental, Rehabilitative and Restorative Service Providers
Profile Score
Detailed profile(88/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
18 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
326 Summerset St
Fontanelle, IA 50846-8098
Phone: (615) 896-6400
Fax: (615) 896-5177
Street-level locationGet directions
Mailing address
624 W North St
Madrid, IA 50156-1024
Registry dates
- Enumerated
- 2008-02-19
- Last updated
- 2008-02-19
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.