Individual provider Active NPI

Jenine Cook, OTR-L

  • Occupational Therapist
  • Tempe, AZ
National Provider Identifier
1093853111
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
0113 Issued in AZ
Practice address
1835 E Guadalupe Rd
Ste 103
Tempe, AZ 85283-3277
Phone
(480) 456-0942
Fax
(480) 456-0956
NPI assigned
Feb 1, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 0113 AZ Primary

Addresses

Primary practice location

1835 E Guadalupe Rd
Ste 103
Tempe, AZ 85283-3277

Mailing address

601 W Belmont Ave
Phoenix, AZ 85021-7262
Phone (602) 216-9475

Other identifiers 1

IdentifierTypeStateIssuer
829294MedicaidAZ

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

LicenseStateTypeSpecialty
0113AZMDOccupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1170288000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1093853111",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 W BELMONT AVE",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850217262",
            "telephone_number": "602-216-9475"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1835 E GUADALUPE RD",
            "address_2": "STE 103",
            "city": "TEMPE",
            "state": "AZ",
            "postal_code": "852833277",
            "telephone_number": "480-456-0942",
            "fax_number": "480-456-0956"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COOK",
        "first_name": "JENINE",
        "name_prefix": "Ms.",
        "credential": "OTR-L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-01",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "AZ",
            "license": "0113",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "829294",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tempe, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.