Active NPI
Ladonnaa Renee Jordon
- Environmental Modification Occupational Therapy Assistant
- Selma, AL
National Provider Identifier
1689108300
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Environmental Modification Occupational Therapy Assistant
- License
- 5418
- Practice address
- 11 Bell Rd
Selma, AL 36701-6793 - Phone
- (334) 874-7425
- NPI assigned
- Apr 19, 2017
- Last updated
- Jan 15, 2021
- 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 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapy Assistant | 224Z00000X | 5418 | AL | |
| Environmental Modification Occupational Therapy Assistant | 224ZE0001X | 1137 | TN | |
| Environmental Modification Occupational Therapy Assistant | 224ZE0001X | 5418 | AL | Primary |
Addresses
Primary practice location
11 Bell Rd
Selma, AL 36701-6793
Mailing address
99 Clayhill Rd # NA
Thomasville, AL 36784-4728
Phone (615) 473-0508
Other practice location 1
316 Shoshone Pl
na
Murfreesboro, TN 37128-2860
Phone (615) 473-0508
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 |
|---|---|---|---|
| 5418 | AL | MD | Environmental Modification Occupational Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1492560000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1610668800000",
"number": "1689108300",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "99 CLAYHILL RD # NA",
"city": "THOMASVILLE",
"state": "AL",
"postal_code": "367844728",
"telephone_number": "615-473-0508"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11 BELL RD",
"city": "SELMA",
"state": "AL",
"postal_code": "367016793",
"telephone_number": "334-874-7425"
}
],
"practiceLocations": [
{
"address_1": "316 Shoshone Pl",
"address_2": "na",
"address_purpose": "LOCATION",
"city": "Murfreesboro",
"state": "TN",
"postal_code": "371282860",
"country_code": "US",
"telephone_number": "615-473-0508",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "JORDON",
"first_name": "LADONNAA",
"middle_name": "RENEE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2017-04-19",
"last_updated": "2021-01-15",
"certification_date": "2021-01-15",
"status": "A"
},
"taxonomies": [
{
"code": "224Z00000X",
"taxonomy_group": "",
"desc": "Occupational Therapy Assistant",
"state": "AL",
"license": "5418",
"primary": false
},
{
"code": "224ZE0001X",
"taxonomy_group": "",
"desc": "Occupational Therapy Assistant, Environmental Modification",
"state": "TN",
"license": "1137",
"primary": false
},
{
"code": "224ZE0001X",
"taxonomy_group": "",
"desc": "Occupational Therapy Assistant, Environmental Modification",
"state": "AL",
"license": "5418",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Selma, AL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.