Active NPI
Jennifer Helen Peterman, COTA/L
- Occupational Therapy Assistant
- Avon, OH
National Provider Identifier
1679229157
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapy Assistant
- License
- OTA007497
- 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
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 |
|---|---|---|---|---|
| Occupational Therapy Assistant | 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
| License | State | Type | Specialty |
|---|---|---|---|
| OTA007497 | OH | MD | Occupational 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.