Individual provider Active NPI

Jennifer Helen Peterman, COTA/L

  • Occupational Therapy Assistant
  • Avon, OH
National Provider Identifier
1679229157
Registry record updated Feb 23, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Therapy AssistantTaxonomy code 224Z00000X
License
OTA007497 Issued in OH
Practice address
37900 Chester Rd
Avon, OH 44011-1044
Phone
(440) 695-7100
NPI assigned
Feb 23, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 23, 2022

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: 193400000X SINGLE SPECIALTY GROUP 224Z00000X OTA007497 OH Primary

Addresses

Primary practice location

37900 Chester Rd
Avon, OH 44011-1044

Mailing address

32883 Walnut Dr
Avon, OH 44011-1466
Phone (217) 690-7565

Other practice location 1

33200 Health Campus Blvd
Avon, OH 44011-1481
Phone (440) 797-3916

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
OTA007497OHMDOccupational Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1645574400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1645574400000",
    "number": "1679229157",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "32883 WALNUT DR",
            "city": "AVON",
            "state": "OH",
            "postal_code": "440111466",
            "telephone_number": "217-690-7565"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "37900 CHESTER RD",
            "city": "AVON",
            "state": "OH",
            "postal_code": "440111044",
            "telephone_number": "440-695-7100"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "33200 Health Campus Blvd",
            "address_purpose": "LOCATION",
            "city": "Avon",
            "state": "OH",
            "postal_code": "440111481",
            "country_code": "US",
            "telephone_number": "440-797-3916",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PETERMAN",
        "first_name": "JENNIFER",
        "middle_name": "HELEN",
        "credential": "COTA/L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-02-23",
        "last_updated": "2022-02-23",
        "certification_date": "2022-02-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Occupational Therapy Assistant",
            "state": "OH",
            "license": "OTA007497",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Avon, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 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.

Verify at the official NPI Registry.