Active NPI
Jeannine Kathleen Colburn
- Occupational Therapist
- Jamestown, ND
National Provider Identifier
1508990193
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 33
- Practice address
- 701 3Rd St NW
Jamestown, ND 58401-2963 - Phone
- (701) 252-3850
- Fax
- (701) 952-5154
- NPI assigned
- Mar 15, 2007
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 33 | ND | Primary |
Addresses
Primary practice location
701 3Rd St NW
Jamestown, ND 58401-2963
Mailing address
701 3Rd St NW
Jamestown, ND 58401-2963
Phone (701) 252-3850
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 59899 | Medicaid | ND | |
| 23196 | Other | ND | BCBS OF NORTH DAKOTA |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 33 | ND | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1173916800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183939200000",
"number": "1508990193",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "701 3RD ST NW",
"city": "JAMESTOWN",
"state": "ND",
"postal_code": "584012963",
"telephone_number": "701-252-3850",
"fax_number": "701-952-5154"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "701 3RD ST NW",
"city": "JAMESTOWN",
"state": "ND",
"postal_code": "584012963",
"telephone_number": "701-252-3850",
"fax_number": "701-952-5154"
}
],
"practiceLocations": [],
"basic": {
"last_name": "COLBURN",
"first_name": "JEANNINE",
"middle_name": "KATHLEEN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-03-15",
"last_updated": "2007-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "ND",
"license": "33",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "59899",
"state": "ND"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS OF NORTH DAKOTA",
"identifier": "23196",
"state": "ND"
}
],
"endpoints": [],
"other_names": []
}Other providers in Jamestown, ND
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.