Nicole Jenkins, OTR

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

118064 Issued in TX

Practice address

715 Church Street
Bluff Dale, TX 76433

Phone

(209) 840-4155

NPI assigned

Nov 18, 2019

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

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Specialty

Occupational Therapist in Private Practice

Education

Other, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Cerda Pediatric and Neuro Physical Therapy PLLCGroup PAC ID 9638513252, 4 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Cerda Pediatric & Neuro Physical Therapy PLLC

  • Physical Therapist
  • Fort Worth, TX
  • NPI 1801664073

  Occupational Therapist

  Medicare reassignment Care Compare group NPD
• Healthpro Heritage Rehab & Fitness, LLC

  • Physical Therapist
  • Georgetown, TX
  • NPI 1952531154

  Occupational Therapist

  Medicare reassignment NPD
• Healthpro Heritage Rehab & Fitness, LLC

  • Physical Therapist
  • Independence, MO
  • NPI 1871072462

  Occupational Therapist

  NPD

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

{
    "created_epoch": "1574035200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1574812800000",
    "number": "1265077986",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "715 CHURCH STREET",
            "city": "BLUFF DALE",
            "state": "TX",
            "postal_code": "76433",
            "telephone_number": "209-840-4155"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "715 CHURCH STREET",
            "city": "BLUFF DALE",
            "state": "TX",
            "postal_code": "76433",
            "telephone_number": "209-840-4155"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JENKINS",
        "first_name": "NICOLE",
        "credential": "OTR",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-11-18",
        "last_updated": "2019-11-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "TX",
            "license": "118064",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bluff Dale Independent School District
• Michelle Campbell, CCC-SLP, BCBA
• Cary Byron Clark, MD
• Jennifer Jean Donwerth, ANP-BC, GNP-BC
• Brooke Harris, LPC
• Lactation Connection
• Jonathan Mark Owens, OT
• Pathways Early Autism Intervention
• Cristina Rangel Uribe
• Eric Thompson, FNP

• Occupational Therapist in Bluff Dale, TX
• Providers in Bluff Dale, TX by specialty
• Occupational Therapist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.