Active NPI
Jessica Banner, OTR/L
- Occupational Therapist
- New York, NY
National Provider Identifier
1235375189
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 011711
- Practice address
- 250 W 89TH St
3E
New York, NY 10024-1700 - Phone
- (201) 755-6620
- NPI assigned
- Dec 24, 2008
- 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 | 011711 | NY | Primary |
Addresses
Primary practice location
250 W 89TH St
3E
New York, NY 10024-1700
Mailing address
250 W 89TH St
3E
New York, NY 10024-1700
Phone (201) 755-6620
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 |
|---|---|---|---|
| 011711 | NY | MD | Occupational Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1230076800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1230076800000",
"number": "1235375189",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "250 W 89TH ST",
"address_2": "3E",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100241700",
"telephone_number": "201-755-6620"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "250 W 89TH ST",
"address_2": "3E",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100241700",
"telephone_number": "201-755-6620"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BANNER",
"first_name": "JESSICA",
"name_prefix": "Ms.",
"credential": "OTR/L",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-12-24",
"last_updated": "2008-12-24",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "NY",
"license": "011711",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in New York, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 24, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.