Active NPI
Jennifer Lundquist, OTR/L
- Occupational Therapist
- Shelburne, VT
National Provider Identifier
1386018505
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 072.0061249
- Practice address
- 185 Pine Haven Shores Rd
Shelburne, VT 05482-7805 - Phone
- (443) 928-0344
- NPI assigned
- Nov 27, 2015
- Last updated
- Nov 27, 2015
- Sex
- Female
- Sole proprietor
- No
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 | 072.0061249 | VT | Primary |
Addresses
Primary practice location
185 Pine Haven Shores Rd
Shelburne, VT 05482-7805
Mailing address
1726 North Rd
Hinesburg, VT 05461-9691
Phone (443) 928-0344
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 |
|---|---|---|---|
| 072.0061249 | VT | MD | Occupational Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Powerback Rehabilitation LLC | Occupational Therapist | 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba Powerback Rehabilitation
- Physical Therapist
- Woodbridge, VA
- NPI 1790640761
Occupational Therapist
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1448582400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1448582400000",
"number": "1386018505",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1726 NORTH RD",
"city": "HINESBURG",
"state": "VT",
"postal_code": "054619691",
"telephone_number": "443-928-0344"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "185 PINE HAVEN SHORES RD",
"city": "SHELBURNE",
"state": "VT",
"postal_code": "054827805",
"telephone_number": "443-928-0344"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LUNDQUIST",
"first_name": "JENNIFER",
"credential": "OTR/L",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-11-27",
"last_updated": "2015-11-27",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "VT",
"license": "072.0061249",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Shelburne, VT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.