Active NPI
Jenna Knutson
- Occupational Therapy Assistant
- Thornton, CO
National Provider Identifier
1417618299
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapy Assistant
- License
- 1536
- Practice address
- 12080 Bellaire Way
Thornton, CO 80241-3600 - Phone
- (303) 450-2700
- NPI assigned
- Jan 4, 2022
- Sex
- Female
- Sole proprietor
- Yes
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 Therapy Assistant | 224Z00000X | 1536 | IA | Primary |
Addresses
Primary practice location
12080 Bellaire Way
Thornton, CO 80241-3600
Mailing address
1181 E 1St Ave Apt 1828
Broomfield, CO 80020-3764
Phone (563) 379-8786
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
| License | State | Type | Specialty |
|---|---|---|---|
| 1536 | IA | MD | Occupational Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1641254400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1641254400000",
"number": "1417618299",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1181 E 1ST AVE APT 1828",
"city": "BROOMFIELD",
"state": "CO",
"postal_code": "800203764",
"telephone_number": "563-379-8786"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12080 BELLAIRE WAY",
"city": "THORNTON",
"state": "CO",
"postal_code": "802413600",
"telephone_number": "303-450-2700"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KNUTSON",
"first_name": "JENNA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2022-01-04",
"last_updated": "2022-01-04",
"certification_date": "2021-12-30",
"status": "A"
},
"taxonomies": [
{
"code": "224Z00000X",
"taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
"desc": "Occupational Therapy Assistant",
"state": "IA",
"license": "1536",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Thornton, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.