Jenna Daulton, COTA/L

Primary specialty

Occupational Therapy AssistantTaxonomy code 224Z00000X

License

05068 Issued in OH

Practice address

1500 Villa Rd
Springfield, OH 45503-1656

Phone

(937) 342-8424

NPI assigned

Jul 30, 2015

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1438214400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1438214400000",
    "number": "1477939502",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "333 S BIRD RD",
            "city": "SPRINGFIELD",
            "state": "OH",
            "postal_code": "455051609",
            "telephone_number": "614-857-5602"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 VILLA RD",
            "city": "SPRINGFIELD",
            "state": "OH",
            "postal_code": "455031656",
            "telephone_number": "937-342-8424"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAULTON",
        "first_name": "JENNA",
        "credential": "COTA/L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-07-30",
        "last_updated": "2015-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "OH",
            "license": "05068",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LISCENSURE",
            "identifier": "05068",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Occupational Therapy Assistant in Springfield, OH
• Providers in Springfield, OH by specialty
• Occupational Therapy Assistant in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 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.