Active NPI
Jennifer Willis
- Occupational Therapist
- Scottsville, KY
National Provider Identifier
1174285837
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 273351
- Practice address
- 456 Burnley Rd
Scottsville, KY 42164-6355 - Phone
- (270) 622-2800
- NPI assigned
- Oct 11, 2021
- Last updated
- Oct 11, 2021
- 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 Therapist | 225X00000X | 273351 | KY | Primary |
Addresses
Primary practice location
456 Burnley Rd
Scottsville, KY 42164-6355
Mailing address
94 Jack Brown Rd
Glasgow, KY 42141-8237
Phone (270) 670-7039
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 |
|---|---|---|---|
| 273351 | KY | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1633910400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1633910400000",
"number": "1174285837",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "94 JACK BROWN RD",
"city": "GLASGOW",
"state": "KY",
"postal_code": "421418237",
"telephone_number": "270-670-7039"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "456 BURNLEY RD",
"city": "SCOTTSVILLE",
"state": "KY",
"postal_code": "421646355",
"telephone_number": "270-622-2800"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILLIS",
"first_name": "JENNIFER",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-10-11",
"last_updated": "2021-10-11",
"certification_date": "2021-10-11",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "KY",
"license": "273351",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Scottsville, KY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.