Individual provider Active NPI

Ladonnaa Renee Jordon

  • Environmental Modification Occupational Therapy Assistant
  • Selma, AL
National Provider Identifier
1689108300
Registry record updated Jan 15, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Environmental Modification Occupational Therapy AssistantTaxonomy code 224ZE0001X
License
5418 Issued in AL
Practice address
11 Bell Rd
Selma, AL 36701-6793
Phone
(334) 874-7425
NPI assigned
Apr 19, 2017
Last updated
Jan 15, 2021By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 15, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
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

LicenseStateTypeSpecialty
5418ALMDEnvironmental 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.

Verify at the official NPI Registry.