Jennifer Bothast

Primary specialty

Occupational Therapy AssistantTaxonomy code 224Z00000X

License

5593 Issued in SC

Practice address

7143 Narrow Lane Rd
Smyrna, SC 29743-7746

Phone

(904) 755-2900

NPI assigned

Oct 24, 2023

Last updated

Oct 24, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1698105600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698105600000",
    "number": "1396517256",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7143 NARROW LANE RD",
            "city": "SMYRNA",
            "state": "SC",
            "postal_code": "297437746",
            "telephone_number": "904-755-2900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7143 NARROW LANE RD",
            "city": "SMYRNA",
            "state": "SC",
            "postal_code": "297437746",
            "telephone_number": "904-755-2900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOTHAST",
        "first_name": "JENNIFER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-10-24",
        "last_updated": "2023-10-24",
        "certification_date": "2023-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "SC",
            "license": "5593",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michael R Burnett, RNFA
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• Occupational Therapy Assistant in Smyrna, SC
• Providers in Smyrna, SC by specialty
• Occupational Therapy Assistant in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2023; 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.