Jerelyn Susan Denkins, COTA L

Primary specialty

Occupational Therapy AssistantTaxonomy code 224Z00000X

License

1124 Issued in NC

Practice address

103 S Erfie Dr
Pinebluff, NC 28373-8296

Phone

(910) 528-4465

NPI assigned

Jun 14, 2007

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 identifiers 1

Other names 1

• Ms. Jerelyn Susan Moore Other 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": "1181779200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1376747121",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "103 S ERFIE DR",
            "city": "PINEBLUFF",
            "state": "NC",
            "postal_code": "283738296",
            "telephone_number": "910-528-4465"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "103 S ERFIE DR",
            "city": "PINEBLUFF",
            "state": "NC",
            "postal_code": "283738296",
            "telephone_number": "910-528-4465"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DENKINS",
        "first_name": "JERELYN",
        "middle_name": "SUSAN",
        "name_prefix": "Ms.",
        "credential": "COTA L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-06-14",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "NC",
            "license": "1124",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OTA L",
            "identifier": "1124",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JERELYN",
            "last_name": "MOORE",
            "middle_name": "SUSAN",
            "prefix": "MS.",
            "credential": "COTA L",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Occupational Therapy Assistant in Pinebluff, NC
• Providers in Pinebluff, NC by specialty
• Occupational Therapy Assistant in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.