Jennifer Green, COTA/L

Primary specialty

Occupational Therapy AssistantTaxonomy code 224Z00000X

License

OTA16652 Issued in FL

Practice address

448 Pendrey Dr
Port Orange, FL 32127-9528

Phone

(386) 215-2961

NPI assigned

Aug 8, 2018

Last updated

Aug 8, 2018By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1533686400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1533686400000",
    "number": "1134608458",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "448 PENDREY DR",
            "city": "PORT ORANGE",
            "state": "FL",
            "postal_code": "321279528",
            "telephone_number": "386-215-2961"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "448 PENDREY DR",
            "city": "PORT ORANGE",
            "state": "FL",
            "postal_code": "321279528",
            "telephone_number": "386-215-2961"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREEN",
        "first_name": "JENNIFER",
        "credential": "COTA/L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-08-08",
        "last_updated": "2018-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "376K00000X",
            "taxonomy_group": "",
            "desc": "Nurse's Aide",
            "state": "FL",
            "license": "CNA338144",
            "primary": false
        },
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "FL",
            "license": "OTA16652",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mona Granger-Prouty
• Michelle Graser
• Lakisha Gray
• Great Strides Rehabilitation Inc. (Great Strides Rehabilitation)
• Ashley Green, LCSW
• Melanie Green
• Sarah Greene
• Lauren Gremminger
• Lloyd George Griffith Jr., RPH
• Grimes Neurology and Concussion Center, P.a.

• Occupational Therapy Assistant in Port Orange, FL
• Providers in Port Orange, FL by specialty
• Occupational Therapy Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2018; 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.