Jennifer Ann Clark, OTD, OTR/L

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

2015003683 Issued in MO

Practice address

4 Arnold Mall
Arnold, MO 63010-2223

Phone

(636) 282-0056

NPI assigned

Mar 26, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Jennifer Ann Hefner Former name

Medicare fee-for-service enrollment

Enrolled in MO

Enrollment records 1

Specialty

Occupational Therapist in Private Practice

Education

Other, 2014

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Kandu Medical Services West PC

  • Neurology Physician
  • Van Nuys, CA
  • NPI 1821859661

  MO

  Medicare reassignment

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1522022400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1522022400000",
    "number": "1720583446",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9910 BENBURY CT",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631281569"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4 ARNOLD MALL",
            "city": "ARNOLD",
            "state": "MO",
            "postal_code": "630102223",
            "telephone_number": "636-282-0056"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "JENNIFER",
        "middle_name": "ANN",
        "credential": "OTD, OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-03-26",
        "last_updated": "2018-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "MO",
            "license": "2015003683",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNIFER",
            "last_name": "HEFNER",
            "middle_name": "ANN",
            "credential": "OTD, OTR/L",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Christopher M Schrick OD LLC
• Mallory Paige Cicchillo
• Taylor Cissell, OTR/L
• Cheryl Ann Clark, PHARMD
• Elyssia Mae Clark, DC
• Clarkson Optometry Inc
• Clarkson Optometry, Inc
• Laura M Clements, MOT, OTR/L
• Isabel Clobes, RD,LD
• Jonathan Cochran

• Occupational Therapist in Arnold, MO
• Providers in Arnold, MO by specialty
• Occupational Therapist in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.