Jenna Brooke Jennings, OTR, MOT

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

121161 Issued in TX

Practice address

630 Stoneglen Dr
Keller, TX 76248-1316

Phone

(817) 734-6515

Fax

(817) 717-8584

NPI assigned

Sep 9, 2020

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

Other names 1

• Miss Jena Brooke Lightfoot 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": "1599609600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1599609600000",
    "number": "1346855111",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "630 STONEGLEN DR",
            "city": "KELLER",
            "state": "TX",
            "postal_code": "762481316",
            "telephone_number": "817-734-6515",
            "fax_number": "817-717-8584"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "630 STONEGLEN DR",
            "city": "KELLER",
            "state": "TX",
            "postal_code": "762481316",
            "telephone_number": "817-734-6515",
            "fax_number": "817-717-8584"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JENNINGS",
        "first_name": "JENNA",
        "middle_name": "BROOKE",
        "name_prefix": "Mrs.",
        "credential": "OTR, MOT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-09-09",
        "last_updated": "2020-09-09",
        "certification_date": "2020-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "TX",
            "license": "121161",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENA",
            "last_name": "LIGHTFOOT",
            "middle_name": "BROOKE",
            "prefix": "MISS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• JC Medical Enterprises, Inc
• JD Hospice LLC
• Jeffrey a. Hoffman, D.D.S.
• Amanda Dawn Jenkins, DC
• Katherine M Jenkins, MS CCC-SLP
• Christina Nichole Jimenez, PHARMD.
• Megan Jodray, PHARMD
• Taylor J Johnsen, PA-C
• Bethany K Johnson, CPM, LM
• Gregory Paul Johnson, PT, DPT

• Occupational Therapist in Keller, TX
• Providers in Keller, TX by specialty
• Occupational Therapist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2020; 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.