Individual provider Active NPI

Jennifer Gail Decatur, COTA/L

  • Occupational Therapy Assistant
  • Keene, NH
National Provider Identifier
1023551231
Registry record updated Nov 21, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Therapy AssistantTaxonomy code 224Z00000X
License
0748 Issued in NH
Practice address
677 Court St
Keene, NH 03431-1702
Phone
(603) 354-4157
NPI assigned
Nov 21, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 21, 2016

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy Assistant 224Z00000X 0748 NH Primary

Addresses

Primary practice location

677 Court St
Keene, NH 03431-1702

Mailing address

14 Longmeadow Dr
Troy, NH 03465-2302
Phone (603) 903-2000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1479686400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1479686400000",
    "number": "1023551231",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14 LONGMEADOW DR",
            "city": "TROY",
            "state": "NH",
            "postal_code": "034652302",
            "telephone_number": "603-903-2000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "677 COURT ST",
            "city": "KEENE",
            "state": "NH",
            "postal_code": "034311702",
            "telephone_number": "603-354-4157"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DECATUR",
        "first_name": "JENNIFER",
        "middle_name": "GAIL",
        "name_prefix": "Miss",
        "credential": "COTA/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-11-21",
        "last_updated": "2016-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "NH",
            "license": "0748",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Keene, NH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.