Individual provider Active NPI

Jennifer J Rundo, COTA/L

  • Occupational Therapy Assistant
  • Streetsboro, OH
National Provider Identifier
1457744203
Registry record updated Mar 17, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Therapy AssistantTaxonomy code 224Z00000X
License
04949 Issued in OH
Practice address
1645 Maplewood Dr
Streetsboro, OH 44241-5662
Phone
(330) 626-3031
Fax
(330) 626-2699
NPI assigned
Mar 17, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2015

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 04949 OH Primary

Addresses

Primary practice location

1645 Maplewood Dr
Streetsboro, OH 44241-5662

Mailing address

1645 Maplewood Dr
Streetsboro, OH 44241-5662
Phone (330) 626-3031

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
04949OHMDOccupational Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1426550400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1426550400000",
    "number": "1457744203",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1645 MAPLEWOOD DR",
            "city": "STREETSBORO",
            "state": "OH",
            "postal_code": "442415662",
            "telephone_number": "330-626-3031",
            "fax_number": "330-626-2699"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1645 MAPLEWOOD DR",
            "city": "STREETSBORO",
            "state": "OH",
            "postal_code": "442415662",
            "telephone_number": "330-626-3031",
            "fax_number": "330-626-2699"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUNDO",
        "first_name": "JENNIFER",
        "middle_name": "J",
        "name_prefix": "Mrs.",
        "credential": "COTA/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-03-17",
        "last_updated": "2015-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "OH",
            "license": "04949",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Streetsboro, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 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.

Verify at the official NPI Registry.