Jennifer Fay Bean Bradford, COTA/L

Primary specialty

Occupational Therapy AssistantTaxonomy code 224Z00000X

License

OTA0000001397 Issued in TN

Practice address

1397 S College St
Winchester, TN 37398-2414

Phone

(931) 962-3225

Fax

(931) 962-3103

NPI assigned

Jul 8, 2008

Sex

Female

Sole proprietor

No

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

• Miss Jennifer Fay Bean Former name

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jul 8, 2008.

{
    "created_epoch": "1215475200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1215475200000",
    "number": "1497918643",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4",
            "city": "WINCHESTER",
            "state": "TN",
            "postal_code": "373980004",
            "telephone_number": "931-962-3225",
            "fax_number": "931-962-3103"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1397 S COLLEGE ST",
            "city": "WINCHESTER",
            "state": "TN",
            "postal_code": "373982414",
            "telephone_number": "931-962-3225",
            "fax_number": "931-962-3103"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BEAN BRADFORD",
        "first_name": "JENNIFER",
        "middle_name": "FAY",
        "name_prefix": "Mrs.",
        "credential": "COTA/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-07-08",
        "last_updated": "2008-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "TN",
            "license": "OTA0000001397",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNIFER",
            "last_name": "BEAN",
            "middle_name": "FAY",
            "prefix": "MISS",
            "credential": "COTA/L",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Occupational Therapy Assistant in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.