Healthcare Provider Details

I. General information

NPI: 1003623653
Provider Name (Legal Business Name): ZACHARY DOUGLAS JEPPSON MOT, OTR/L
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/17/2024
Last Update Date: 03/12/2025
Certification Date: 03/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2706 SPOTSWOOD TRL
ROCKINGHAM VA
22801-2213
US

IV. Provider business mailing address

1034 BLUE RIDGE DR APT 3
HARRISONBURG VA
22802-4980
US

V. Phone/Fax

Practice location:
  • Phone: 540-437-4226
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number0119010766
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: