Active NPI
Jennifer Lynn O'Leary, OTRL
- Occupational Therapist
- Spring Lake, NC
National Provider Identifier
1720643547
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 12504
- Practice address
- 103 Sleepy Dr Ste G
Spring Lake, NC 28390-3319 - Phone
- (910) 587-6065
- NPI assigned
- May 7, 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 | 12504 | NC | Primary |
Addresses
Primary practice location
103 Sleepy Dr Ste G
Spring Lake, NC 28390-3319
Mailing address
1031 Shell Dr Apt 120
Spring Lake, NC 28390-2068
Phone (269) 615-5083
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 |
|---|---|---|---|
| 12504 | NC | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1557187200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1557187200000",
"number": "1720643547",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1031 SHELL DR APT 120",
"city": "SPRING LAKE",
"state": "NC",
"postal_code": "283902068",
"telephone_number": "269-615-5083"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "103 SLEEPY DR STE G",
"city": "SPRING LAKE",
"state": "NC",
"postal_code": "283903319",
"telephone_number": "910-587-6065"
}
],
"practiceLocations": [],
"basic": {
"last_name": "O'LEARY",
"first_name": "JENNIFER",
"middle_name": "LYNN",
"credential": "OTRL",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-05-07",
"last_updated": "2019-05-07",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "NC",
"license": "12504",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Spring Lake, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 7, 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.