Active NPI
Jennifer Pung, OTR/L
- Occupational Therapist
- Tallmadge, OH
National Provider Identifier
1588230973
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 011488
- Practice address
- 619 Northwest Ave
Tallmadge, OH 44278-1203 - Phone
- (234) 274-1888
- NPI assigned
- May 27, 2021
- Last updated
- May 27, 2021
- 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 | 011488 | OH | Primary |
Addresses
Primary practice location
619 Northwest Ave
Tallmadge, OH 44278-1203
Mailing address
114 Hemlock Dr
Cuyahoga FLS, OH 44223-1235
Phone (330) 858-7043
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 |
|---|---|---|---|
| 011488 | OH | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1622073600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1622073600000",
"number": "1588230973",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "114 HEMLOCK DR",
"city": "CUYAHOGA FLS",
"state": "OH",
"postal_code": "442231235",
"telephone_number": "330-858-7043"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "619 NORTHWEST AVE",
"city": "TALLMADGE",
"state": "OH",
"postal_code": "442781203",
"telephone_number": "234-274-1888"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PUNG",
"first_name": "JENNIFER",
"credential": "OTR/L",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-05-27",
"last_updated": "2021-05-27",
"certification_date": "2021-05-27",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "OH",
"license": "011488",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Tallmadge, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.