Jermain McNeel Tezeno, OTR, PT

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

OT 12890 Issued in FL

Practice address

1422 San Marco Blvd
Jacksonville, FL 32207-8536

Phone

(904) 398-4133

NPI assigned

Sep 21, 2007

Last updated

Jul 10, 2008By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1190332800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1215648000000",
    "number": "1548456684",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3717 SHADY MAPLE DR",
            "city": "LITHONIA",
            "state": "GA",
            "postal_code": "300383346"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1422 SAN MARCO BLVD",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322078536",
            "telephone_number": "904-398-4133"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TEZENO",
        "first_name": "JERMAIN",
        "middle_name": "MCNEEL",
        "name_prefix": "Mr.",
        "credential": "OTR, PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-09-21",
        "last_updated": "2008-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PT 23875",
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "FL",
            "license": "OT 12890",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Testing in Motion LLC
• Prabhu Dutt Tewari, MD
• Cheryl Nicole Thacker, AGPCNP-BC
• Corey Thacker
• Chelsey Thackston, NP
• Bidong Thai, MD
• Stacy Ann Thalassites, APRN

• Occupational Therapist in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Occupational Therapist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 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.