Individual provider Active NPI

Jennifer Flenorl, PT

  • Physical Therapist
  • Jackson, TN
National Provider Identifier
1366966475
Registry record updated Jul 19, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT34711 Issued in FL
Practice address
1378 Union University Dr
Jackson, TN 38305-3780
Phone
(731) 664-7060
Fax
(731) 664-5005
NPI assigned
Jul 31, 2017
Last updated
Jul 19, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 19, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 11246 TN
Physical Therapist 225100000X PT34711 FL Primary

Addresses

Primary practice location

1378 Union University Dr
Jackson, TN 38305-3780

Mailing address

1804 Highway 45 Byp Ste 604
Jackson, TN 38305-4403
Phone (731) 660-7971

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL n/a

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
11246TNMDPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist

NPI Registry JSON

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

{
    "created_epoch": "1501459200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1563494400000",
    "number": "1366966475",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1804 HIGHWAY 45 BYP STE 604",
            "city": "JACKSON",
            "state": "TN",
            "postal_code": "383054403",
            "telephone_number": "731-660-7971",
            "fax_number": "731-660-8739"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1378 UNION UNIVERSITY DR",
            "city": "JACKSON",
            "state": "TN",
            "postal_code": "383053780",
            "telephone_number": "731-664-7060",
            "fax_number": "731-664-5005"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FLENORL",
        "first_name": "JENNIFER",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-07-31",
        "last_updated": "2019-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TN",
            "license": "11246",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PT34711",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "n/a",
            "affiliation": "N",
            "address_1": "1378 Union University Dr",
            "city": "Jackson",
            "state": "TN",
            "country_code": "US",
            "postal_code": "383053780",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Jackson, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2019; 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.