Individual provider Active NPI

Jennifer Marie Martinc, OTR/L

  • Occupational Therapy Assistant
  • Lutz, FL
National Provider Identifier
1174803001
Registry record updated Oct 27, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Therapy AssistantTaxonomy code 224Z00000X
License
OTA11831 Issued in FL
Practice address
16102 N. Florida Avenue
Lutz, FL 33549
Phone
(813) 873-1936
NPI assigned
Aug 23, 2011
Last updated
Oct 27, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 27, 2016

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy Assistant 224Z00000X OTA11831 FL Primary
Occupational Therapist 225X00000X OT17869 FL
Community Health Worker 172V00000X OTA11831 FL

Addresses

Primary practice location

16102 N. Florida Avenue
Lutz, FL 33549

Mailing address

9730 Lake Chase Island Way
Tampa, FL 33626
Phone (216) 323-6405

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
OTA11831FLMDCommunity Health Worker

NPI Registry JSON

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

{
    "created_epoch": "1314057600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1477526400000",
    "number": "1174803001",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9730 LAKE CHASE ISLAND WAY",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "33626",
            "telephone_number": "216-323-6405"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16102 N. FLORIDA AVENUE",
            "city": "LUTZ",
            "state": "FL",
            "postal_code": "33549",
            "telephone_number": "813-873-1936"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTINC",
        "first_name": "JENNIFER",
        "middle_name": "MARIE",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-08-23",
        "last_updated": "2016-10-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "FL",
            "license": "OTA11831",
            "primary": true
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "FL",
            "license": "OT17869",
            "primary": false
        },
        {
            "code": "172V00000X",
            "taxonomy_group": "",
            "desc": "Community Health Worker",
            "state": "FL",
            "license": "OTA11831",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lutz, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2016; 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.