Individual provider Active NPI

Jennifer Rose Martin Fell, OTR,L

  • Occupational Therapist
  • Columbia, MO
National Provider Identifier
1154468544
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
2004019119 Issued in MO
Practice address
1600 E Broadway
Columbia, MO 65201-5844
Phone
(573) 815-2734
Fax
(573) 815-2605
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 2004019119 MO Primary

Addresses

Primary practice location

1600 E Broadway
Columbia, MO 65201-5844

Mailing address

3008 Joshua Tree CT
Columbia, MO 65202-3453
Phone (573) 886-5551

Other names 1

  • Jennifer Rose Martin Former name

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
2004019119MOMDOccupational 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": "1154468544",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3008 JOSHUA TREE CT",
            "city": "COLUMBIA",
            "state": "MO",
            "postal_code": "652023453",
            "telephone_number": "573-886-5551"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 E BROADWAY",
            "city": "COLUMBIA",
            "state": "MO",
            "postal_code": "652015844",
            "telephone_number": "573-815-2734",
            "fax_number": "573-815-2605"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FELL",
        "first_name": "JENNIFER",
        "middle_name": "ROSE MARTIN",
        "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": "MO",
            "license": "2004019119",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNIFER",
            "last_name": "MARTIN",
            "middle_name": "ROSE",
            "credential": "OTR,L",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Columbia, MO

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.