Jennifer Faike, MS, OTR/L

Key facts

NPI

1124466883

Entity type

Individual (NPI type 1)

Primary specialty

Occupational Therapist 225X00000X

License

OT.0004358 (CO)

Practice address

29036 Pine Rd
Evergreen, CO 80439-7429

Phone

(303) 709-8757

NPI assigned

Jun 4, 2013

Sex

Female

Sole proprietor

No

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 and National Provider Directory roles.

• Promising Pathways, LLC Occupational Therapist · Evergreen, CO · NPI 1154028850
  NPD Authorized official OCCUPATIONAL THERAPIST

Medicare participation

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)

No

Credentials

Master of Science

State licenses

Practice roles

Specialties & licenses

Addresses

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Jan 18, 2023.

{
    "created_epoch": "1370304000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1674000000000",
    "number": "1124466883",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29036 PINE RD",
            "city": "EVERGREEN",
            "state": "CO",
            "postal_code": "804397429",
            "telephone_number": "303-709-8757"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "29036 PINE RD",
            "city": "EVERGREEN",
            "state": "CO",
            "postal_code": "804397429",
            "telephone_number": "303-709-8757"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAIKE",
        "first_name": "JENNIFER",
        "credential": "MS, OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-06-04",
        "last_updated": "2023-01-18",
        "certification_date": "2023-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "OR",
            "license": "1074566",
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "AK",
            "license": "1860",
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "CO",
            "license": "OT.0004358",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Evergreen Vision Clinic, PC
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• Caryl Fank, P.T.A.
• Kathleen Farrell
• Suzanne Gaye Feist-Matson, MA, LPC
• Laura Duvall Ferguson, LCSW

All providers in Evergreen, CO · Occupational Therapist in Colorado