Autumn N Jessen, COTA

Primary specialty

Occupational Therapy AssistantTaxonomy code 224Z00000X

License

OT-A492 Issued in AR

Practice address

17706 I-30 Ste 3
Benton, AR 72019-2930

Phone

(501) 315-4414

Fax

(501) 315-3467

NPI assigned

Nov 19, 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

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": "1195430400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1195430400000",
    "number": "1396926309",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17706 I-30 STE 3",
            "city": "BENTON",
            "state": "AR",
            "postal_code": "720192930",
            "telephone_number": "501-315-4414",
            "fax_number": "501-315-3467"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17706 I-30 STE 3",
            "city": "BENTON",
            "state": "AR",
            "postal_code": "720192930",
            "telephone_number": "501-315-4414",
            "fax_number": "501-315-3467"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JESSEN",
        "first_name": "AUTUMN",
        "middle_name": "N",
        "credential": "COTA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-11-19",
        "last_updated": "2007-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "AR",
            "license": "OT-A492",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Morgan Lee Jenkins I
• Janna Lyn Jennings, M.D.
• Sarah Ann Jennings, LPN
• Jerry W. Dixon, M.D., P.a.
• Lucille Jerry, RECOVERY ASSISTANT
• JLM Ventures, Inc.
• JLM Ventures, Inc.
• JM Psychiatry PLLC
• John V. Baka M.D.P.a
• Erika Johninson, RECOVERY ASSISTANT

• Occupational Therapy Assistant in Benton, AR
• Providers in Benton, AR by specialty
• Occupational Therapy Assistant in Arkansas

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