Active NPI
Jennifer Jeanne Soros, MOT, OTR/L
- Occupational Therapist
- Highland Heights, OH
National Provider Identifier
1063736353
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- OT.007508
- Practice address
- 685 Kenbridge Dr
Highland Heights, OH 44143-1926 - Phone
- (216) 202-0429
- NPI assigned
- Mar 16, 2010
- Last updated
- Aug 10, 2021
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | OT.007508 | OH | Primary |
Addresses
Primary practice location
685 Kenbridge Dr
Highland Heights, OH 44143-1926
Mailing address
685 Kenbridge Dr
Highland Heights, OH 44143-1926
Phone (216) 202-0429
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0028740 | Other | OH | JEN KUNDRACH |
| 0028740 | Medicaid | OH | |
| 8959042 | Medicaid | OH |
Other names 1
- Jennifer Jeanne Kundrach
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 |
|---|---|---|---|
| OT.007508 | OH | MD | Occupational Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Kidslink Connect, LLC | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
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- Streetsboro, OH
- NPI 1114413093
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1268697600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1628553600000",
"number": "1063736353",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "685 KENBRIDGE DR",
"city": "HIGHLAND HEIGHTS",
"state": "OH",
"postal_code": "441431926",
"telephone_number": "216-202-0429"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "685 KENBRIDGE DR",
"city": "HIGHLAND HEIGHTS",
"state": "OH",
"postal_code": "441431926",
"telephone_number": "216-202-0429"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SOROS",
"first_name": "JENNIFER",
"middle_name": "JEANNE",
"credential": "MOT, OTR/L",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2010-03-16",
"last_updated": "2021-08-10",
"certification_date": "2021-08-10",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "OH",
"license": "OT.007508",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "JEN KUNDRACH",
"identifier": "0028740",
"state": "OH"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0028740",
"state": "OH"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "8959042",
"state": "OH"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "JENNIFER",
"last_name": "KUNDRACH",
"middle_name": "JEANNE",
"credential": "MOT, OTR/L",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Highland Heights, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.