Individual provider Active NPI

Jennifer Ann Slater, LMT

  • Specialist
  • La Pine, OR
National Provider Identifier
1487899183
Registry record updated Dec 9, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
LMT 14772 Issued in OR
Practice address
16639 Box Way
Suite a
La Pine, OR 97739
Phone
(541) 536-7515
NPI assigned
Dec 9, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 9, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X LMT 14772 OR Primary

Addresses

Primary practice location

16639 Box Way
Suite a
La Pine, OR 97739

Mailing address

16060 Wright Ave
La Pine, OR 97739-9756
Phone (541) 610-6355

Other identifiers 1

IdentifierTypeStateIssuer
613539800OtherOROWCP U.S. DEPT. OF LABOR

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
LMT 14772ORMDSpecialist

NPI Registry JSON

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

{
    "created_epoch": "1228780800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1228780800000",
    "number": "1487899183",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16060 WRIGHT AVE",
            "city": "LA PINE",
            "state": "OR",
            "postal_code": "977399756",
            "telephone_number": "541-610-6355",
            "fax_number": "541-536-3170"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16639 BOX WAY",
            "address_2": "SUITE A",
            "city": "LA PINE",
            "state": "OR",
            "postal_code": "97739",
            "telephone_number": "541-536-7515"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SLATER",
        "first_name": "JENNIFER",
        "middle_name": "ANN",
        "credential": "LMT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-12-09",
        "last_updated": "2008-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "OR",
            "license": "LMT 14772",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OWCP U.S. DEPT. OF LABOR",
            "identifier": "613539800",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in La Pine, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2008; 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.