=====================================================
General NPI Number Information
=====================================================
NPI Number | 1215856067
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | JARROD DAVID DOTSON OTR
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/14/2026
-----------------------------------------------------
Last Update Date | 07/14/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 3310 TATES CREEK RD
-----------------------------------------------------
City | LEXINGTON
-----------------------------------------------------
State | KY
-----------------------------------------------------
Zip | 40502-3487
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 859-266-2129
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 141 S HILL RD
-----------------------------------------------------
City | VERSAILLES
-----------------------------------------------------
State | KY
-----------------------------------------------------
Zip | 40383-1394
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 859-492-8169
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 225X00000X
-----------------------------------------------------
Taxonomy Name | Occupational Therapist
-----------------------------------------------------
License Number | 166833
-----------------------------------------------------
License Number State | KY
-----------------------------------------------------