Active NPI
Jennifer G Burgess, OT
- Occupational Therapist
- Chattanooga, TN
National Provider Identifier
1376532416
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- OT 02430
- Practice address
- 509 Highview Cir
Chattanooga, TN 37415-2910 - Phone
- (423) 280-1524
- Fax
- (423) 875-2908
- NPI assigned
- Oct 20, 2005
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | OT 02430 | TN | Primary |
Addresses
Primary practice location
509 Highview Cir
Chattanooga, TN 37415-2910
Mailing address
509 Highview Cir
Chattanooga, TN 37415-2910
Phone (423) 280-1524
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3656354 | Medicaid | TN |
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
| License | State | Type | Specialty |
|---|---|---|---|
| OT 02430 | TN | MD | Occupational Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Team Centers Inc | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Psychologist
- Chattanooga, TN
- NPI 1992793012
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1129766400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1321401600000",
"number": "1376532416",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "509 HIGHVIEW CIR",
"city": "CHATTANOOGA",
"state": "TN",
"postal_code": "374152910",
"telephone_number": "423-280-1524",
"fax_number": "423-875-2908"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "509 HIGHVIEW CIR",
"city": "CHATTANOOGA",
"state": "TN",
"postal_code": "374152910",
"telephone_number": "423-280-1524",
"fax_number": "423-875-2908"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BURGESS",
"first_name": "JENNIFER",
"middle_name": "G",
"credential": "OT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2005-10-20",
"last_updated": "2011-11-16",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "TN",
"license": "OT 02430",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "3656354",
"state": "TN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Chattanooga, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.