Active NPI
Jennifer Faith Heller, OTR
- Pediatric Occupational Therapist
- Atlanta, GA
National Provider Identifier
1639204050
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Occupational Therapist
- License
- 4936
- Practice address
- 1935 Cliff Valley Way NE Ste 119
Atlanta, GA 30329-2435 - Phone
- (404) 636-5272
- Fax
- (404) 636-5644
- NPI assigned
- Feb 23, 2007
- 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 |
|---|---|---|---|---|
| Pediatric Occupational Therapist | 225XP0200X | 4936 | GA | Primary |
Addresses
Primary practice location
1935 Cliff Valley Way NE Ste 119
Atlanta, GA 30329-2435
Mailing address
1935 Cliff Valley Way NE Ste 119
Atlanta, GA 30329-2435
Phone (404) 636-5272
Other practice location 1
20310 19th Ave NE
Shoreline, WA 98155-1261
Phone (206) 367-5853
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 |
|---|---|---|---|
| 4936 | GA | MD | Pediatric Occupational Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Child & Family Mental Health Services LLC | Past | Accepting new patients | |
| Sensawee Play | Past | Accepting new patients | |
| PT & OT of Washington, LLC | Past | Accepting new patients |
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 and National Provider Directory roles.
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Shoreline, WA
- NPI 1689242968
-
dba Pediatric PT & OT Services
- Clinic/Center
- Shoreline, WA
- NPI 1356415756
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1172188800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1658361600000",
"number": "1639204050",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1935 CLIFF VALLEY WAY NE STE 119",
"city": "ATLANTA",
"state": "GA",
"postal_code": "303292435",
"telephone_number": "404-636-5272",
"fax_number": "404-636-5644"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1935 CLIFF VALLEY WAY NE STE 119",
"city": "ATLANTA",
"state": "GA",
"postal_code": "303292435",
"telephone_number": "404-636-5272",
"fax_number": "404-636-5644"
}
],
"practiceLocations": [
{
"address_1": "20310 19th Ave NE",
"address_purpose": "LOCATION",
"city": "Shoreline",
"state": "WA",
"postal_code": "981551261",
"country_code": "US",
"telephone_number": "206-367-5853",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "HELLER",
"first_name": "JENNIFER",
"middle_name": "FAITH",
"credential": "OTR",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-02-23",
"last_updated": "2022-07-21",
"status": "A"
},
"taxonomies": [
{
"code": "225XP0200X",
"taxonomy_group": "",
"desc": "Occupational Therapist, Pediatrics",
"state": "GA",
"license": "4936",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Atlanta, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.