Individual provider Active NPI

Jennifer Marie Jurch

  • Developmental Therapist
  • Hudson, FL
National Provider Identifier
1184050163
Registry record updated Sep 23, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Developmental TherapistTaxonomy code 222Q00000X
Practice address
12413 White Bluff Rd
Hudson, FL 34669-5016
Phone
(727) 741-3405
Fax
(727) 213-6246
NPI assigned
Sep 23, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 23, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Developmental Therapist 222Q00000X Primary

Addresses

Primary practice location

12413 White Bluff Rd
Hudson, FL 34669-5016

Mailing address

2427 14TH St N
St Petersburg, FL 33704-3123
Phone (843) 819-4819

Other names 1

  • Jennifer Hines 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

NPI Registry JSON

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

{
    "created_epoch": "1379894400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1379894400000",
    "number": "1184050163",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2427 14TH ST N",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337043123",
            "telephone_number": "843-819-4819",
            "fax_number": "727-213-6246"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12413 WHITE BLUFF RD",
            "city": "HUDSON",
            "state": "FL",
            "postal_code": "346695016",
            "telephone_number": "727-741-3405",
            "fax_number": "727-213-6246"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JURCH",
        "first_name": "JENNIFER",
        "middle_name": "MARIE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-09-23",
        "last_updated": "2013-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "222Q00000X",
            "taxonomy_group": "",
            "desc": "Developmental Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNIFER",
            "last_name": "HINES",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Hudson, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2013; 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.