Jennifer O

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

PC009195 Issued in PA

Practice address

1310 Valley View Blvd
Altoona, PA 16602-6080

Phone

(814) 944-9970

Fax

(814) 944-9974

NPI assigned

Feb 13, 2017

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

Other names 1

• Jennifer Mardis Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Blair Family Solutions, LLC

  • Community/Behavioral Health Agency
  • Altoona, PA
  • NPI 1720133218
  NPD

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

{
    "created_epoch": "1486944000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1486944000000",
    "number": "1437698347",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1310 VALLEY VIEW BLVD",
            "city": "ALTOONA",
            "state": "PA",
            "postal_code": "166026080",
            "telephone_number": "814-944-9970",
            "fax_number": "814-944-9974"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1310 VALLEY VIEW BLVD",
            "city": "ALTOONA",
            "state": "PA",
            "postal_code": "166026080",
            "telephone_number": "814-944-9970",
            "fax_number": "814-944-9974"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "O",
        "first_name": "JENNIFER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-02-13",
        "last_updated": "2017-02-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "PA",
            "license": "PC009195",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNIFER",
            "last_name": "MARDIS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Daniel T Novak Jr., DMD
• Tierra Lynn Novak
• Novum Laboratory, LLC
• Nutronics TM, Inc.
• Russell Paul Nycum, PMHNP-BC
• Stacey O'Connor
• Peter Joseph O'Donnell, PSYCHOLOGIST
• Sarah Nicole O'Farrell, PA-C
• Nicole Marie O'Neill, PT, DPT
• Rahaf Obeid, PHARMD

• Professional Counselor in Altoona, PA
• Providers in Altoona, PA by specialty
• Professional Counselor in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.