Individual provider Active NPI

Jennifer Haglund, COTA

  • Occupational Therapy Assistant
  • Brandon, FL
National Provider Identifier
1346459773
Registry record updated May 11, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Therapy AssistantTaxonomy code 224Z00000X
License
000934 Issued in CT
Practice address
851 W Lumsden Rd
Brandon, FL 33511-6280
Phone
(813) 661-8998
NPI assigned
May 22, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 11, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy Assistant 224Z00000X 000934 CT Primary

Addresses

Primary practice location

851 W Lumsden Rd
Brandon, FL 33511-6280

Mailing address

6207 Tanager PL
Temple Terrace, FL 33617-9300
Phone (203) 314-8811

Other practice location 1

1 Care Ln
West Haven, CT 06516-2601
Phone (203) 934-7955

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

LicenseStateTypeSpecialty
000934CTMDPhysical Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1179792000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620691200000",
    "number": "1346459773",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6207 TANAGER PL",
            "city": "TEMPLE TERRACE",
            "state": "FL",
            "postal_code": "336179300",
            "telephone_number": "203-314-8811"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "851 W LUMSDEN RD",
            "city": "BRANDON",
            "state": "FL",
            "postal_code": "335116280",
            "telephone_number": "813-661-8998"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1 Care Ln",
            "address_purpose": "LOCATION",
            "city": "West Haven",
            "state": "CT",
            "postal_code": "065162601",
            "country_code": "US",
            "telephone_number": "203-934-7955",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HAGLUND",
        "first_name": "JENNIFER",
        "credential": "COTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-22",
        "last_updated": "2021-05-11",
        "certification_date": "2021-05-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "CT",
            "license": "000934",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brandon, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 2021; 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.