Jennifer Thacker

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

R1290 Issued in KY

Practice address

4200 Browns LN
Louisville, KY 40220-1523

Phone

(502) 459-8900

NPI assigned

Nov 27, 2013

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

Other names 1

• Jennifer Ryan Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1385510400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1385510400000",
    "number": "1306277496",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3507 STONY BROOK DR",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402991541",
            "telephone_number": "502-494-4246"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4200 BROWNS LN",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402201523",
            "telephone_number": "502-459-8900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THACKER",
        "first_name": "JENNIFER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-11-27",
        "last_updated": "2013-11-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "KY",
            "license": "R1290",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNIFER",
            "last_name": "RYAN",
            "credential": "OTR/L",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Daniel B Tew Jr., OD
• Julie Aryn Tewell, M.ED, BCBA, LBA
• Matthew Tewell
• Mary Lorene Texas, N.P.
• TH Consultancy LLC
• Noah Steven Thackeray
• Thad R. Schulten PSC
• Alexander Thai
• Julie Thake, PTA
• Ashish Thaker, DC

• Occupational Therapist in Louisville, KY
• Providers in Louisville, KY by specialty
• Occupational Therapist in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 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.