Individual provider Active NPI

Jennifer Flores, COTA

  • Occupational Therapy Assistant
  • Rio Rancho, NM
National Provider Identifier
1447610860
Registry record updated Feb 26, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Therapy AssistantTaxonomy code 224Z00000X
License
2138 Issued in NM
Practice address
4210 Sabana Grande Ave SE
Rio Rancho, NM 87124-1152
Phone
(505) 816-7534
NPI assigned
Feb 26, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 26, 2016

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 2138 NM Primary

Addresses

Primary practice location

4210 Sabana Grande Ave SE
Rio Rancho, NM 87124-1152

Mailing address

6432 Michelangelo LN NW
Albuquerque, NM 87114-5018
Phone (575) 519-0078

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
2138NMMDMassage Therapist

NPI Registry JSON

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

{
    "created_epoch": "1456444800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1456444800000",
    "number": "1447610860",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6432 MICHELANGELO LN NW",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871145018",
            "telephone_number": "575-519-0078"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4210 SABANA GRANDE AVE SE",
            "city": "RIO RANCHO",
            "state": "NM",
            "postal_code": "871241152",
            "telephone_number": "505-816-7534"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FLORES",
        "first_name": "JENNIFER",
        "credential": "COTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-02-26",
        "last_updated": "2016-02-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "NM",
            "license": "2138",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rio Rancho, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 2016; 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.