Individual provider Active NPI

Jennifer Kacey Barber, COTA/L

  • Occupational Therapy Assistant
  • Beavercreek, OH
National Provider Identifier
1417351107
Registry record updated Oct 9, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Therapy AssistantTaxonomy code 224Z00000X
License
OTA03706 Issued in OH
Practice address
2679 Crone Rd
Beavercreek, OH 45434-6652
Phone
(937) 554-1463
NPI assigned
Oct 9, 2014
Last updated
Oct 9, 2014By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 9, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy Assistant 224Z00000X OTA03706 OH Primary

Addresses

Primary practice location

2679 Crone Rd
Beavercreek, OH 45434-6652

Mailing address

2679 Crone Rd
Beavercreek, OH 45434-6652
Phone (937) 554-1463

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
OTA03706OHMDOccupational Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1412812800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1412812800000",
    "number": "1417351107",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2679 CRONE RD",
            "city": "BEAVERCREEK",
            "state": "OH",
            "postal_code": "454346652",
            "telephone_number": "937-554-1463"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2679 CRONE RD",
            "city": "BEAVERCREEK",
            "state": "OH",
            "postal_code": "454346652",
            "telephone_number": "937-554-1463"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BARBER",
        "first_name": "JENNIFER",
        "middle_name": "KACEY",
        "credential": "COTA/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-10-09",
        "last_updated": "2014-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "OH",
            "license": "OTA03706",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Beavercreek, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2014; 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.