Individual provider Active NPI

Kristen Leeanne Jones, COTA

  • Occupational Therapy Assistant
  • Gainesville, FL
National Provider Identifier
1669016325
Registry record updated Nov 5, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Therapy AssistantTaxonomy code 224Z00000X
License
OTA17150 Issued in FL
Practice address
250 NW 76TH Dr
Gainesville, FL 32607-6668
Phone
(352) 505-6363
NPI assigned
Nov 5, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 5, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy AssistantGroup: 193200000X MULTI-SPECIALTY GROUP 224Z00000X OTA17150 FL Primary

Addresses

Primary practice location

250 NW 76TH Dr
Gainesville, FL 32607-6668

Mailing address

2330 SW Williston Rd Apt 2934
Gainesville, FL 32608-4092
Phone (352) 584-3696

Other identifiers 1

IdentifierTypeStateIssuer
OTA17150MedicaidFL

Electronic endpoints 4

TypeEndpointUseAffiliation
Other URL Gainesville
Other URL Gainesville
Other URL Gainesville
Other URL Gainesville

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
OTA17150FLMDOccupational Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1572912000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1572912000000",
    "number": "1669016325",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2330 SW WILLISTON RD APT 2934",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326084092",
            "telephone_number": "352-584-3696"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "250 NW 76TH DR",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326076668",
            "telephone_number": "352-505-6363"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JONES",
        "first_name": "KRISTEN",
        "middle_name": "LEEANNE",
        "credential": "COTA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-11-05",
        "last_updated": "2019-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapy Assistant",
            "state": "FL",
            "license": "OTA17150",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "OTA17150",
            "state": "FL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "Gainesville",
            "affiliation": "N",
            "endpointDescription": "secure email associated with work",
            "address_1": "2330 SW Williston Rd Apt 2934",
            "city": "Gainesville",
            "state": "FL",
            "country_code": "US",
            "postal_code": "326084092",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "Gainesville",
            "affiliation": "N",
            "endpointDescription": "secure email associated with work",
            "address_1": "2330 SW Williston Rd Apt 2934",
            "city": "Gainesville",
            "state": "FL",
            "country_code": "US",
            "postal_code": "326084092",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "Gainesville",
            "affiliation": "N",
            "endpointDescription": "secure email associated with work",
            "address_1": "2330 SW Williston Rd Apt 2934",
            "city": "Gainesville",
            "state": "FL",
            "country_code": "US",
            "postal_code": "326084092",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "Gainesville",
            "affiliation": "N",
            "endpointDescription": "secure email associated with work",
            "address_1": "2330 SW Williston Rd Apt 2934",
            "city": "Gainesville",
            "state": "FL",
            "country_code": "US",
            "postal_code": "326084092",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Gainesville, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2019; 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.