Jennifer Colleen Whitaker, MOT R L

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

3202 Issued in AZ

Practice address

11800 West Thompson Ranch
El Mirage, AZ 85335

Phone

(623) 523-8487

NPI assigned

Feb 6, 2007

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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": "1170720000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1184763823",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8556 W SUNNYSLOPE LN",
            "city": "PEORIA",
            "state": "AZ",
            "postal_code": "853455362",
            "telephone_number": "623-523-8487"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11800 WEST THOMPSON RANCH",
            "city": "EL MIRAGE",
            "state": "AZ",
            "postal_code": "85335",
            "telephone_number": "623-523-8487"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHITAKER",
        "first_name": "JENNIFER",
        "middle_name": "COLLEEN",
        "credential": "MOT R L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-06",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "AZ",
            "license": "3202",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "889313",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Occupational Therapist in El Mirage, AZ
• Providers in El Mirage, AZ by specialty
• Occupational Therapist in Arizona

• 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.