Jennifer Clark Johnson, OTR/L

Primary specialty

Pediatric Occupational TherapistTaxonomy code 225XP0200X

License

1002972 Issued in OR

Practice address

408 NE Hawthorne Ave
Bend, OR 97701-4729

Phone

(541) 604-0548

NPI assigned

Feb 18, 2013

Last updated

Feb 18, 2013By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Blossom Therapeutics, LLC

  • Pediatric Occupational Therapist
  • Bend, OR
  • NPI 1700354040

  Pediatrics

  NPD (past) Authorized official

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

{
    "created_epoch": "1361145600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1361145600000",
    "number": "1265772974",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "855 NW HALEAKALA WAY",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977016726",
            "telephone_number": "541-604-0548"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "408 NE HAWTHORNE AVE",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977014729",
            "telephone_number": "541-604-0548"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "JENNIFER",
        "middle_name": "CLARK",
        "credential": "OTR/L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-02-18",
        "last_updated": "2013-02-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "OR",
            "license": "1002972",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elizabeth Marsh Johnson
• Gabrielle Johnson
• James Edward Johnson, MD
• Jeffrey J. Johnson, D.D.S.
• Jenna Rae Johnson, LCSW
• Joel Allen Johnson, NP-BC
• Kendall M Johnson
• Kimberly Anne Johnson, MS, CCC-SLP
• Kristina Anne Johnson, RN
• Kylie R. Johnson, CRM

• Pediatric Occupational Therapist in Bend, OR
• Providers in Bend, OR by specialty
• Pediatric Occupational Therapist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 2013; 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.