Active NPI
Jennifer Kay Herron
- Pediatric Occupational Therapist
- Saint Louis, MO
National Provider Identifier
1669696647
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Occupational Therapist
- License
- 2003000562
- Practice address
- 801 N 11TH St
Medicaid Department
Saint Louis, MO 63101-1015 - Phone
- (314) 345-2535
- Fax
- (314) 345-2653
- NPI assigned
- Apr 12, 2007
- Sex
- Female
- Sole proprietor
- Yes
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 | 2003000562 | MO | Primary |
Addresses
Primary practice location
801 N 11TH St
Medicaid Department
Saint Louis, MO 63101-1015
Mailing address
721 N McKnight Rd
Apt B
Saint Louis, MO 63132-4931
Phone (314) 692-2494
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 |
|---|---|---|---|
| 2003000562 | MO | MD | Pediatric Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1176336000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1669696647",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "721 N MCKNIGHT RD",
"address_2": "APT B",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "631324931",
"telephone_number": "314-692-2494"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "801 N 11TH ST",
"address_2": "MEDICAID DEPARTMENT",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "631011015",
"telephone_number": "314-345-2535",
"fax_number": "314-345-2653"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HERRON",
"first_name": "JENNIFER",
"middle_name": "KAY",
"name_prefix": "Miss",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-04-12",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "225XP0200X",
"taxonomy_group": "",
"desc": "Occupational Therapist, Pediatrics",
"state": "MO",
"license": "2003000562",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Saint Louis, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.