Active NPI
Jamie Jenelle Kentgen, OTR/L
- Occupational Therapist
- St Charles, IL
National Provider Identifier
1598427080
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 056.014522
- Practice address
- 3815 E Main St Ste B
St Charles, IL 60174-2488 - Phone
- (630) 584-7530
- NPI assigned
- Oct 12, 2021
- Last updated
- Oct 14, 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 | 056.014522 | IL | Primary |
Addresses
Primary practice location
3815 E Main St Ste B
St Charles, IL 60174-2488
Mailing address
14 Riverdale CT
Algonquin, IL 60102-6821
Phone (847) 691-1845
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 056.014522 | Other | IL | STATE LICENSE |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 056.014522 | IL | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1633996800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1634169600000",
"number": "1598427080",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "14 RIVERDALE CT",
"city": "ALGONQUIN",
"state": "IL",
"postal_code": "601026821",
"telephone_number": "847-691-1845"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3815 E MAIN ST STE B",
"city": "ST CHARLES",
"state": "IL",
"postal_code": "601742488",
"telephone_number": "630-584-7530"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KENTGEN",
"first_name": "JAMIE",
"middle_name": "JENELLE",
"credential": "OTR/L",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-10-12",
"last_updated": "2021-10-14",
"certification_date": "2021-10-14",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "IL",
"license": "056.014522",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STATE LICENSE",
"identifier": "056.014522",
"state": "IL"
}
],
"endpoints": [],
"other_names": []
}Other providers in St Charles, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 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.