Jaxon Bennett
Individual provider Active NPI Occupational Therapist · Palmer, AK
NPI 1245938141 · NPPES record last updated Feb 20, 2023
Key facts
- NPI
- 1245938141
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Occupational Therapist 225X00000X
- License
- 204733 (AK)
- Practice address
- 304 W Evergreen Ave Ste 101
Palmer, AK 99645-6970 - Phone
- (907) 745-8686
- NPI assigned
- Feb 20, 2023
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 204733 | AK | MD | Occupational Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Select Physical Therapy Holdings Inc | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 204733 | AK | Yes |
Addresses
Primary practice location
304 W Evergreen Ave Ste 101
Palmer, AK 99645-6970
Mailing address
304 W Evergreen Ave Ste 101
Palmer, AK 99645-6970
Other providers in Palmer, AK
- Daniel E Beistline
- Caitlin Bell
- Jacki Bell
- Amanda Bellamy
- Paul R Bendle II
- Apryl R Benson
- Benteh Medevac LLC
- Lauren Berberich
- Leslie Lauren Berberich
- Holly Michele Berger
All providers in Palmer, AK · Occupational Therapist in Alaska
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 20, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.