Individual provider Active NPI

Jenny Bury, OTR

  • Occupational Therapist
  • Green Bay, WI
National Provider Identifier
1366638322
Registry record updated Dec 28, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
4125 Issued in WI
Practice address
2121 S Oneida St Ste a
Green Bay, WI 54304-4617
Phone
(920) 209-0012
NPI assigned
Sep 23, 2007
Last updated
Dec 28, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 28, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 4125 WI Primary

Addresses

Primary practice location

2121 S Oneida St Ste a
Green Bay, WI 54304-4617

Mailing address

W7842 Airport Rd Apt East
Crivitz, WI 54114-7455

Other practice location 1

2150 Memorial Dr
Stuite 106
Green Bay, WI 54303-6335
Phone (920) 639-5366

Other names 1

  • Jenny Allard Former name

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
4125WIMDOccupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1190505600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1672185600000",
    "number": "1366638322",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "W7842 AIRPORT RD APT EAST",
            "city": "CRIVITZ",
            "state": "WI",
            "postal_code": "541147455"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2121 S ONEIDA ST STE A",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543044617",
            "telephone_number": "920-209-0012"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2150 Memorial Dr",
            "address_2": "Stuite 106",
            "address_purpose": "LOCATION",
            "city": "Green Bay",
            "state": "WI",
            "postal_code": "543036335",
            "country_code": "US",
            "telephone_number": "920-639-5366",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BURY",
        "first_name": "JENNY",
        "credential": "OTR",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-09-23",
        "last_updated": "2022-12-28",
        "certification_date": "2022-12-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "WI",
            "license": "4125",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNY",
            "last_name": "ALLARD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Green Bay, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 28, 2022; 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.