Active NPI
Jennifer Wellman, OTR/L
- Occupational Therapist
- Medford, NY
National Provider Identifier
1497253116
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- Practice address
- 12 Platinum CT Ste B
Medford, NY 11763-2247 - Phone
- (631) 320-3692
- NPI assigned
- Jan 28, 2018
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | Primary |
Addresses
Primary practice location
12 Platinum CT Ste B
Medford, NY 11763-2247
Mailing address
20 Barracuda Rd
East Quogue, NY 11942-4916
Phone (941) 928-2358
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)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Reliance Healthcare | Occupational Therapist | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Occupational Therapist
- Bellmore, NY
- NPI 1205085172
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1517097600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1517097600000",
"number": "1497253116",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "20 BARRACUDA RD",
"city": "EAST QUOGUE",
"state": "NY",
"postal_code": "119424916",
"telephone_number": "941-928-2358"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12 PLATINUM CT STE B",
"city": "MEDFORD",
"state": "NY",
"postal_code": "117632247",
"telephone_number": "631-320-3692"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WELLMAN",
"first_name": "JENNIFER",
"credential": "OTR/L",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2018-01-28",
"last_updated": "2018-01-28",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Medford, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.