Active NPI
Jessica Leah Hafner, OT
- Occupational Therapist
- Albuquerque, NM
National Provider Identifier
1477128791
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- OT26037
- Practice address
- 3530 Pan American Fwy NE Ste D
Albuquerque, NM 87107-4793 - Phone
- (505) 888-4469
- NPI assigned
- May 20, 2021
- Last updated
- Jun 28, 2024
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | OT26037 | CA | Primary |
| Occupational Therapist | 225X00000X | NU |
Addresses
Primary practice location
3530 Pan American Fwy NE Ste D
Albuquerque, NM 87107-4793
Mailing address
739B Mountain Laurel Cir SE
Albuquerque, NM 87116-1248
Phone (719) 314-8850
Other practice location 1
325 S Main St Ste A
Belen, NM 87002-3503
Phone (505) 321-5371
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 |
|---|---|---|---|
| OT26037 | CA | MD | Occupational Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Sunshine Kids Therapy, LLC | Past | Accepting new patients | |
| Kidpower Therapy Associates | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Specialist
- Albuquerque, NM
- NPI 1700997863
-
- Physical Therapy Clinic/Center
- Belen, NM
- NPI 1619482064
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1621468800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1719532800000",
"number": "1477128791",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "739B MOUNTAIN LAUREL CIR SE",
"city": "ALBUQUERQUE",
"state": "NM",
"postal_code": "871161248",
"telephone_number": "719-314-8850"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3530 PAN AMERICAN FWY NE STE D",
"city": "ALBUQUERQUE",
"state": "NM",
"postal_code": "871074793",
"telephone_number": "505-888-4469"
}
],
"practiceLocations": [
{
"address_1": "325 S Main St Ste A",
"address_purpose": "LOCATION",
"city": "Belen",
"state": "NM",
"postal_code": "870023503",
"country_code": "US",
"telephone_number": "505-321-5371",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "HAFNER",
"first_name": "JESSICA",
"middle_name": "LEAH",
"credential": "OT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-05-20",
"last_updated": "2024-06-28",
"certification_date": "2024-06-28",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "CA",
"license": "OT26037",
"primary": true
},
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "NU",
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Albuquerque, NM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.