Active NPI
Jennifer Lynn Anderson
- Occupational Therapy Assistant
- Albany, GA
National Provider Identifier
1114368685
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapy Assistant
- License
- OTA001028
- Practice address
- 3716 Gateway Ave
Albany, GA 31721-9247 - Phone
- (404) 821-6757
- NPI assigned
- Jul 12, 2013
- 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 |
|---|---|---|---|---|
| Occupational Therapy Assistant | 224Z00000X | OTA001028 | GA | Primary |
Addresses
Primary practice location
3716 Gateway Ave
Albany, GA 31721-9247
Mailing address
3716 Gateway Ave
Albany, GA 31721-9247
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| OTA001028 | Other | GA | OCCUPATIONAL THERAPY ASSISTANT LICENSE |
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 |
|---|---|---|---|
| OTA001028 | GA | MD | Occupational Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1373587200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1373587200000",
"number": "1114368685",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3716 GATEWAY AVE",
"city": "ALBANY",
"state": "GA",
"postal_code": "317219247"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3716 GATEWAY AVE",
"city": "ALBANY",
"state": "GA",
"postal_code": "317219247",
"telephone_number": "404-821-6757"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ANDERSON",
"first_name": "JENNIFER",
"middle_name": "LYNN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-07-12",
"last_updated": "2013-07-12",
"status": "A"
},
"taxonomies": [
{
"code": "224Z00000X",
"taxonomy_group": "",
"desc": "Occupational Therapy Assistant",
"state": "GA",
"license": "OTA001028",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "OCCUPATIONAL THERAPY ASSISTANT LICENSE",
"identifier": "OTA001028",
"state": "GA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Albany, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.