Individual provider Active NPI

Jennifer Sydney Doren, COTA

  • Occupational Therapy Assistant
  • Pembroke Pines, FL
National Provider Identifier
1528465069
Registry record updated Nov 26, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Therapy AssistantTaxonomy code 224Z00000X
License
OTA13489 Issued in FL
Practice address
1021 NW 191St Ave
Pembroke Pines, FL 33029-2921
Phone
(954) 589-3203
NPI assigned
Nov 26, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 26, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy Assistant 224Z00000X OTA13489 FL Primary

Addresses

Primary practice location

1021 NW 191St Ave
Pembroke Pines, FL 33029-2921

Mailing address

1021 NW 191St Ave
Pembroke Pines, FL 33029-2921
Phone (954) 589-3203

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
OTA13489FLMDOccupational Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1416960000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1416960000000",
    "number": "1528465069",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1021 NW 191ST AVE",
            "city": "PEMBROKE PINES",
            "state": "FL",
            "postal_code": "330292921",
            "telephone_number": "954-589-3203"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1021 NW 191ST AVE",
            "city": "PEMBROKE PINES",
            "state": "FL",
            "postal_code": "330292921",
            "telephone_number": "954-589-3203"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOREN",
        "first_name": "JENNIFER",
        "middle_name": "SYDNEY",
        "name_prefix": "Ms.",
        "credential": "COTA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-11-26",
        "last_updated": "2014-11-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "FL",
            "license": "OTA13489",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pembroke Pines, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 26, 2014; 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.