Individual provider Active NPI

Jennifer Demjanenko, DPT

  • Physical Therapist
  • Cincinnati, OH
National Provider Identifier
1245788702
Registry record updated Nov 23, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT016529 Issued in OH
Practice address
7300 Dearwester Dr
Cincinnati, OH 45236-6119
Phone
(614) 202-5315
NPI assigned
Sep 13, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 23, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT016529 OH Primary

Addresses

Primary practice location

7300 Dearwester Dr
Cincinnati, OH 45236-6119

Mailing address

2860 Observatory Ave
Apt 13
Cincinnati, OH 45208-2359
Phone (614) 202-5315

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

NPI Registry JSON

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

{
    "created_epoch": "1473724800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1479859200000",
    "number": "1245788702",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2860 OBSERVATORY AVE",
            "address_2": "APT 13",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452082359",
            "telephone_number": "614-202-5315"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7300 DEARWESTER DR",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452366119",
            "telephone_number": "614-202-5315"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEMJANENKO",
        "first_name": "JENNIFER",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-09-13",
        "last_updated": "2016-11-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OH",
            "license": "PT016529",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cincinnati, OH

Sources for this page

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