Shelly Rae Jennings, COTA/L

Primary specialty

Occupational Therapy AssistantTaxonomy code 224Z00000X

License

5391 Issued in AZ

Practice address

8540 Scarborough Dr Ste 200
Colorado Springs, CO 80920-7513

Phone

(719) 314-0151

NPI assigned

Oct 7, 2014

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Shelly Rae Fernandez Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1412640000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1412640000000",
    "number": "1568865335",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5027 W MCLELLAN RD",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853014012",
            "telephone_number": "623-349-2020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8540 SCARBOROUGH DR STE 200",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809207513",
            "telephone_number": "719-314-0151"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JENNINGS",
        "first_name": "SHELLY",
        "middle_name": "RAE",
        "credential": "COTA/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-10-07",
        "last_updated": "2014-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "AZ",
            "license": "5391",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SHELLY",
            "last_name": "FERNANDEZ",
            "middle_name": "RAE",
            "credential": "COTA/L",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Lauren Jennings
• Linda M Jennings, RN
• Mia Jean Jennings, O.D.
• Rasheem Antonio Jennings, LPCC
• Scott B Jennings, MD
• Thomas S Jennings, DDS
• Sarah Elizabeth Jennison, DPT
• Jenny Coffey Counseling LLC
• Jenny Coffey Counseling LLC
• Alexandra Hope Jensen

• Occupational Therapy Assistant in Colorado Springs, CO
• Providers in Colorado Springs, CO by specialty
• Occupational Therapy Assistant in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 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.