Individual provider Active NPI

Jennifer R Jones, OTR/L, CHT

  • Occupational Therapist
  • Fairview Heights, IL
National Provider Identifier
1619095437
Registry record updated Feb 14, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
056-006388 Issued in IL
Practice address
5300 N. Illinois
Ste 101
Fairview Heights, IL 62208
Phone
(618) 624-9300
Fax
(618) 624-9330
NPI assigned
Mar 27, 2007
Last updated
Feb 14, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 14, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 056-006388 IL Primary

Addresses

Primary practice location

5300 N. Illinois
Ste 101
Fairview Heights, IL 62208

Mailing address

600 Oakmont LN
Ste 600C
Westmont, IL 60559-5548
Phone (630) 575-1980

Other names 1

  • Jennifer R Fahey Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO, IL2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20100812000777 MO Practitioner - Occupational Therapist in Private Practice 0042344053 Reassigns benefits to 1 organization
I20101012000180 IL Practitioner - Occupational Therapist in Private Practice 0042344053 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Athletico LTDGroup PAC ID 4789602681, shared by 41 NPIs, 2,187 clinicians

Practice addresses (Care Compare)

1050 Admiral Weinel Blvd
Columbia, IL 62236-1988
Phone (618) 693-3100

14825 N Outer 40 Rd
Suite 300
Chesterfield, MO 63017-0002
Phone (636) 812-1211

1832 Wentzville Pkwy
Wentzville, MO 63385-3817
Phone (636) 327-7110

Merit-based Incentive Payment System (MIPS)

Final score
86.32 of 100Reported as group
Quality
84.44
Promoting interoperability
99
Improvement activities
40
Cost
70.78

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
056-006388ILMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Athletico LTD Occupational Therapist CurrentSince Jun 24, 2020 Accepting new patients
Athletico LTD Occupational Therapist Current Accepting new patients
Athletico LTD Occupational Therapist CurrentSince Jun 24, 2020 Accepting new patients

Locations

1050 Admiral Weinel Blvd
Columbia, IL 62236
Phone (618) 693-3100

1047 Century Dr
Edwardsville, IL 62025
Phone (618) 307-3434

5300 N Illinois St
#101
Fairview Hts, IL 62208
Phone (618) 222-2222

280 N Randall Rd
Lake in the Hills, IL 60156
Phone (847) 854-8219

2122 York Rd
Ste 300
Oak Brook, IL 60523
Phone (630) 575-6250

600 Oakmont Ln
Ste 600C
Westmont, IL 60559
Phone (630) 575-6250

2136 William St
Ste 115
Cape Girardeau, MO 63703
Phone (573) 826-4033

1355 Maple St
Farmington, MO 63640
Phone (573) 756-9900

229 S Stewart Rd
Ste E3
Liberty, MO 64068
Phone (816) 656-3695

951 Waterbury Falls Dr
O Fallon, MO 63368
Phone (636) 336-0300

2007 W Foxwood Dr
Ste D
Raymore, MO 64083
Phone (816) 265-8116

107 Concord Plaza Shopping Ctr
Saint Louis, MO 63128
Phone (314) 842-2990

107 Progress Pkwy
Sullivan, MO 63080
Phone (573) 860-5901

1832 Wentzville Pkwy
Wentzville, MO 63385
Phone (636) 327-7110

Interoperability endpoints

  • Direct secure messaging: jennifer.jones.p2@direct.athleticoltd.nextgenshare.com

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1174953600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1581638400000",
    "number": "1619095437",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 OAKMONT LN",
            "address_2": "STE 600C",
            "city": "WESTMONT",
            "state": "IL",
            "postal_code": "605595548",
            "telephone_number": "630-575-1980"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5300 N. ILLINOIS",
            "address_2": "STE 101",
            "city": "FAIRVIEW HEIGHTS",
            "state": "IL",
            "postal_code": "62208",
            "telephone_number": "618-624-9300",
            "fax_number": "618-624-9330"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JONES",
        "first_name": "JENNIFER",
        "middle_name": "R",
        "credential": "OTR/L, CHT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-27",
        "last_updated": "2020-02-14",
        "certification_date": "2020-02-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "IL",
            "license": "056-006388",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNIFER",
            "last_name": "FAHEY",
            "middle_name": "R",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Fairview Heights, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.