Active NPI
Jenna Lastres, OTR/L
- Occupational Therapist
- Bethlehem, PA
National Provider Identifier
1710543426
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- OC015341
- Practice address
- 4161 Douglas Dr
Bethlehem, PA 18020-9306 - Phone
- (484) 550-8118
- NPI assigned
- May 17, 2019
- Sex
- Female
- Sole proprietor
- No
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 Therapist | 225X00000X | OC015341 | PA | Primary |
Addresses
Primary practice location
4161 Douglas Dr
Bethlehem, PA 18020-9306
Mailing address
4161 Douglas Dr
Bethlehem, PA 18020-9306
Phone (484) 550-8118
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 |
|---|---|---|---|
| OC015341 | PA | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1558051200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1558051200000",
"number": "1710543426",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4161 DOUGLAS DR",
"city": "BETHLEHEM",
"state": "PA",
"postal_code": "180209306",
"telephone_number": "484-550-8118"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4161 DOUGLAS DR",
"city": "BETHLEHEM",
"state": "PA",
"postal_code": "180209306",
"telephone_number": "484-550-8118"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LASTRES",
"first_name": "JENNA",
"credential": "OTR/L",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-05-17",
"last_updated": "2019-05-17",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "PA",
"license": "OC015341",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bethlehem, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 17, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.