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NPI Code Detail

MEDICARE: JESSICA PEYTON MUSGROVE MOT, OTR/L

MEDICARE: JESSICA PEYTON MUSGROVE MOT, OTR/L
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225X00000XOccupational Therapist26928FL

General Provider Information

NPI Number : 1912854019
Entity Type Code : Individual
Provider Name (Legal Business Name) : JESSICA PEYTON MUSGROVE MOT, OTR/L
Provider Business Mailing Address
First Line : 104 ASHOURIAN AVE STE 105
Second Line :
City : SAINT AUGUSTINE
State : FL
Zip : 32092-5106
Country : US
Telephone Number : 904-230-7761
Fax Number :
Provider Business Practice Location Address
First Line : 104 ASHOURIAN AVE STE 105
Second Line :
City : SAINT AUGUSTINE
State : FL
Zip : 32092-5106
Country : US
Telephone Number : 904-230-7761
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/16/2026
Last Update Date : 03/16/2026

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