Active NPI
Jenny Gann
- Occupational Therapist
- Siloam Springs, AR
National Provider Identifier
1255791703
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- OTR2457
- Practice address
- 918 S Mount Olive St
Siloam Springs, AR 72761-4220 - Phone
- (479) 967-2322
- NPI assigned
- Feb 26, 2016
- 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 | OTR2457 | AR | Primary |
Addresses
Primary practice location
918 S Mount Olive St
Siloam Springs, AR 72761-4220
Mailing address
PO Drawer 2109
Russellville, AR 72811
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| PENDING | Medicaid | AR |
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 |
|---|---|---|---|
| OTR2457 | AR | MD | Occupational Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Friendship Community Care Inc. | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Comprehensive Outpatient Rehabilitation Facility (CORF)
- Russellville, AR
- NPI 1528144318
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1456444800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1456444800000",
"number": "1255791703",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO DRAWER 2109",
"city": "RUSSELLVILLE",
"state": "AR",
"postal_code": "72811"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "918 S MOUNT OLIVE ST",
"city": "SILOAM SPRINGS",
"state": "AR",
"postal_code": "727614220",
"telephone_number": "479-967-2322"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GANN",
"first_name": "JENNY",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-02-26",
"last_updated": "2016-02-26",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "AR",
"license": "OTR2457",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "PENDING",
"state": "AR"
}
],
"endpoints": [],
"other_names": []
}Other providers in Siloam Springs, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 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.