Active NPI
Jennifer Lynne Roy
- Pediatric Occupational Therapist
- Portland, ME
National Provider Identifier
1720370844
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Occupational Therapist
- License
- OT2517
- Practice address
- 125 Presumpscot St
Portland, ME 04103-5225 - Phone
- (207) 699-5531
- NPI assigned
- May 8, 2011
- 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 |
|---|---|---|---|---|
| Pediatric Occupational Therapist | 225XP0200X | OT2517 | ME | Primary |
Addresses
Primary practice location
125 Presumpscot St
Portland, ME 04103-5225
Mailing address
PO Box 76
Auburn, ME 04212-0076
Phone (207) 576-8589
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in ME
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20210510002478 | ME | Practitioner - Occupational Therapist in Private Practice | 4587073283 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| OT2517 | ME | MD | Pediatric Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1304812800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1304812800000",
"number": "1720370844",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 76",
"city": "AUBURN",
"state": "ME",
"postal_code": "042120076",
"telephone_number": "207-576-8589"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "125 PRESUMPSCOT ST",
"city": "PORTLAND",
"state": "ME",
"postal_code": "041035225",
"telephone_number": "207-699-5531"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROY",
"first_name": "JENNIFER",
"middle_name": "LYNNE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2011-05-08",
"last_updated": "2011-05-08",
"status": "A"
},
"taxonomies": [
{
"code": "225XP0200X",
"taxonomy_group": "",
"desc": "Occupational Therapist, Pediatrics",
"state": "ME",
"license": "OT2517",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Portland, ME
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.