Active NPI
Jennifer Milsap, MOT
- Occupational Therapist
- Bethany, OK
National Provider Identifier
1427367952
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 1669
- Practice address
- 6800 NW 39TH Expy
Bethany, OK 73008-2513 - Phone
- (405) 440-9866
- Fax
- (405) 440-9341
- NPI assigned
- Oct 1, 2010
- 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 | 1669 | OK | Primary |
Addresses
Primary practice location
6800 NW 39TH Expy
Bethany, OK 73008-2513
Mailing address
6800 NW 39TH Expy
Bethany, OK 73008-2513
Phone (405) 440-9866
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 200307270A | Medicaid | OK |
Other names 1
- Jennifer Wallace
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 |
|---|---|---|---|
| 1669 | OK | MD | Certified Respiratory Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1285891200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1445299200000",
"number": "1427367952",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6800 NW 39TH EXPY",
"city": "BETHANY",
"state": "OK",
"postal_code": "730082513",
"telephone_number": "405-440-9866",
"fax_number": "405-440-9341"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6800 NW 39TH EXPY",
"city": "BETHANY",
"state": "OK",
"postal_code": "730082513",
"telephone_number": "405-440-9866",
"fax_number": "405-440-9341"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MILSAP",
"first_name": "JENNIFER",
"credential": "MOT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-10-01",
"last_updated": "2015-10-20",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "OK",
"license": "1669",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "200307270A",
"state": "OK"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "JENNIFER",
"last_name": "WALLACE",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Bethany, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 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.