Active NPI
Jennifer Lisa Colon, CTRS
- Recreation Therapist
- Gainsville, FL
National Provider Identifier
1043738271
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Recreation Therapist
- License
- CTRS63772
- Practice address
- 1601 SW Archer Ave
Gainsville, FL 32608 - Phone
- (352) 376-1611
- NPI assigned
- Sep 8, 2017
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Recreation Therapist | 225800000X | CTRS63772 | NY | Primary |
Addresses
Primary practice location
1601 SW Archer Ave
Gainsville, FL 32608
Mailing address
1601 SW Archer Rd
Recreation Therapy 117C
Gainsville, FL 32608
Other names 1
- Jennifer Lisa Scanlon
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| CTRS63772 | NY | MD | Recreation Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1504828800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1504828800000",
"number": "1043738271",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1601 SW ARCHER RD",
"address_2": "RECREATION THERAPY 117C",
"city": "GAINSVILLE",
"state": "FL",
"postal_code": "32608",
"fax_number": "352-374-6094"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1601 SW ARCHER AVE",
"city": "GAINSVILLE",
"state": "FL",
"postal_code": "32608",
"telephone_number": "352-376-1611"
}
],
"practiceLocations": [],
"basic": {
"last_name": "COLON",
"first_name": "JENNIFER",
"middle_name": "LISA",
"name_prefix": "Ms.",
"credential": "CTRS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-09-08",
"last_updated": "2017-09-08",
"status": "A"
},
"taxonomies": [
{
"code": "225800000X",
"taxonomy_group": "",
"desc": "Recreation Therapist",
"state": "NY",
"license": "CTRS63772",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "JENNIFER",
"last_name": "SCANLON",
"middle_name": "LISA",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Gainsville, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.