Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Jamella Fagan

Individual provider Occupational Therapist · NPI 1972391472

Jamella Fagan is an Occupational Therapist in Private Practice in Philadelphia, Pennsylvania. Qualified in 2024, 2 years ago. Practices as a sole proprietor. Licensed in Pennsylvania.

Years since qualifying
2
Licensed in
PA
In the registry since
2025
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Practice location Address checks out

4619 Chester Ave Apt B210
Philadelphia, PA 19143-3683
Phone: (267) 481-6632
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Occupational Therapist (primary) Taxonomy 225X00000X · Licence OC020735 (PA)

Record details

NPI number1972391472
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorYes
NPI enumeratedApril 25, 2025
Last updated in NPPESApril 25, 2025
Certification dateApril 25, 2025

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyOCCUPATIONAL THERAPIST IN PRIVATE PRACTICE
Medical schoolOTHER
Graduated 2024 (2 years in practice)
Accepts Medicare assignment Not indicated
Practice locations3 on file with Medicare

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