Individual provider Active NPI

Jennifer Jean Roose, OT

  • Occupational Therapist
  • Katy, TX
National Provider Identifier
1649417098
Registry record updated Jun 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
005457 Issued in OH
Practice address
6361 S Stadium LN
Katy, TX 77494-1057
Phone
(281) 237-6647
Fax
(281) 644-1846
NPI assigned
Jan 7, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 19, 2024

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 005457 OH Primary

Addresses

Primary practice location

6361 S Stadium LN
Katy, TX 77494-1057

Mailing address

6361 S Stadium LN
Katy, TX 77494-1057
Phone (281) 237-6647

Other identifiers 1

IdentifierTypeStateIssuer
0747777MedicaidOH

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
005457OHMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Katy Independent School District Occupational Therapist CurrentSince Jun 23, 2024 Accepting new patients
Rise With ABA Past Accepting new patients

Locations

6361 S Stadium Ln
Katy, TX 77494
Phone (281) 237-6647

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": "1231286400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718755200000",
    "number": "1649417098",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6361 S STADIUM LN",
            "city": "KATY",
            "state": "TX",
            "postal_code": "774941057",
            "telephone_number": "281-237-6647",
            "fax_number": "281-644-1846"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6361 S STADIUM LN",
            "city": "KATY",
            "state": "TX",
            "postal_code": "774941057",
            "telephone_number": "281-237-6647",
            "fax_number": "281-644-1846"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROOSE",
        "first_name": "JENNIFER",
        "middle_name": "JEAN",
        "name_prefix": "Mrs.",
        "credential": "OT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-01-07",
        "last_updated": "2024-06-19",
        "certification_date": "2024-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "OH",
            "license": "005457",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0747777",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Katy, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2024; 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.