Individual provider Active NPI

Jennifer Nanette Haydon

  • Occupational Therapist
  • Bellevue, WA
National Provider Identifier
1629409883
Registry record updated Dec 19, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
OT 00003027 Issued in WA
Practice address
12111 NE 1St St
Bellevue, WA 98005-3181
Phone
(425) 456-4144
NPI assigned
Dec 12, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 19, 2013

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 OT 00003027 WA Primary

Addresses

Primary practice location

12111 NE 1St St
Bellevue, WA 98005-3181

Mailing address

12111 NE 1St St
Bellevue, WA 98005-3181

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
OT 00003027WAMDOccupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1386806400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1387411200000",
    "number": "1629409883",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12111 NE 1ST ST",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980053181"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12111 NE 1ST ST",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980053181",
            "telephone_number": "425-456-4144"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAYDON",
        "first_name": "JENNIFER",
        "middle_name": "NANETTE",
        "name_prefix": "Miss",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-12-12",
        "last_updated": "2013-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "WA",
            "license": "OT 00003027",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bellevue, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2013; 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.