Individual provider Active NPI

Jennifer Heck Glazer, OTR/L

  • Pediatric Occupational Therapist
  • Omaha, NE
National Provider Identifier
1629376348
Registry record updated Mar 3, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Occupational TherapistTaxonomy code 225XP0200X
License
197 Issued in NE
Practice address
3226 S 112TH St
Omaha, NE 68144-4708
Phone
(402) 672-6794
NPI assigned
Mar 3, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 3, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Occupational Therapist 225XP0200X 197 NE Primary

Addresses

Primary practice location

3226 S 112TH St
Omaha, NE 68144-4708

Mailing address

105 S 93Rd Ave
Omaha, NE 68114-3805
Phone (402) 392-2802

Other identifiers 1

IdentifierTypeStateIssuer
91182814501MedicaidNE

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

LicenseStateTypeSpecialty
197NEMDPediatric Occupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Just for Kids Therapy, Inc. Past Accepting new patients
Kids on the Move, Inc. Past Accepting new patients

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1299110400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1299110400000",
    "number": "1629376348",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "105 S 93RD AVE",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681143805",
            "telephone_number": "402-392-2802"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3226 S 112TH ST",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681444708",
            "telephone_number": "402-672-6794"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GLAZER",
        "first_name": "JENNIFER",
        "middle_name": "HECK",
        "name_prefix": "Mrs.",
        "credential": "OTR/L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-03-03",
        "last_updated": "2011-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "NE",
            "license": "197",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "91182814501",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Omaha, NE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2011; 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.