Jennifer Russell Kornegay, OTR/L

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

5370 Issued in NC

Practice address

9020 Senca Dr Ste 220
Wilmington, NC 28411-6680

Phone

(910) 264-9317

Fax

(910) 442-8372

NPI assigned

Sep 24, 2024

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NC

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Eastern Therapy Solutions, PLLC

  • Occupational Therapist
  • Wilmington, NC
  • NPI 1073143343
  Medicare reassignment NPD

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

{
    "created_epoch": "1727136000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727136000000",
    "number": "1659198380",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9020 SENCA DR STE 220",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284116680",
            "telephone_number": "910-264-9317",
            "fax_number": "910-442-8372"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9020 SENCA DR STE 220",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284116680",
            "telephone_number": "910-264-9317",
            "fax_number": "910-442-8372"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KORNEGAY",
        "first_name": "JENNIFER",
        "middle_name": "RUSSELL",
        "credential": "OTR/L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-09-24",
        "last_updated": "2024-09-24",
        "certification_date": "2024-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NC",
            "license": "5370",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ashley Blaine Kopa, PSYD
• David Kopaczewski, PHAMD
• Joan E. Korman, SLP
• Lauren Willson Korn, LCSW, MSW, ACSW
• Jeffrey Todd Kornegay, MD
• Karley McKay Kornegay, RBT
• Evgeniy Anatoliy Koshkarov, MD
• Gabrielle Jean Kosobucki
• Kateryna V Kotlyarevska, MD
• Caroline Kotterer, RDN

• Occupational Therapist in Wilmington, NC
• Providers in Wilmington, NC by specialty
• Occupational Therapist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.