Jenny Lynn Gonzalez

Primary specialty

Occupational Therapy AssistantTaxonomy code 224Z00000X

License

5538 Issued in SC

Practice address

1640 Ashley Hall Rd
Charleston, SC 29407-3824

Phone

(774) 721-6452

Fax

(855) 504-4089

NPI assigned

Jul 5, 2023

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Charleston OT LLC

  • Occupational Therapist
  • Charleston, SC
  • NPI 1144679655
  NPD
• Elite Performance Concepts, LLC

  • Clinic/Center
  • Charleston, SC
  • NPI 1548939945
  NPD

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

{
    "created_epoch": "1688515200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1688860800000",
    "number": "1295412856",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "614 WATEREE DR",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294076635",
            "telephone_number": "774-721-6252",
            "fax_number": "855-504-4089"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1640 ASHLEY HALL RD",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294073824",
            "telephone_number": "774-721-6452",
            "fax_number": "855-504-4089"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GONZALEZ",
        "first_name": "JENNY",
        "middle_name": "LYNN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-07-05",
        "last_updated": "2023-07-09",
        "certification_date": "2023-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "SC",
            "license": "5538",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Theresa Sullivan Gonzales, DMD, MS
• Albert David Gonzalez
• Alexus Misiel Gonzalez, MD
• Ana Gonzalez
• David Pamintuan Gonzalez, NP-C
• Jordyn Gonzalez, PT, DPT
• Luisa Gonzalez, ED.S.
• Good Deeds Case Management Services LLC
• Anne Marie Puckhaber Good, MD
• Elicia Goodale

• Occupational Therapy Assistant in Charleston, SC
• Providers in Charleston, SC by specialty
• Occupational Therapy Assistant in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2023; 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.