Jose Enrique Olivencia, OTR/L

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

131789 Issued in KY

Practice address

2100 Millvale Rd
Louisville, KY 40205-1604

Phone

(502) 451-0990

NPI assigned

Dec 7, 2021

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1638835200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638835200000",
    "number": "1720746605",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "206 HIDDEN OAK PL",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402224866",
            "telephone_number": "502-608-5978"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2100 MILLVALE RD",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402051604",
            "telephone_number": "502-451-0990"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLIVENCIA",
        "first_name": "JOSE",
        "middle_name": "ENRIQUE",
        "credential": "OTR/L",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-12-07",
        "last_updated": "2021-12-07",
        "certification_date": "2021-12-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "KY",
            "license": "131789",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Maria Camille Bacci Oliva, APRN
• Olive Grove Counseling
• Olive Tree Counseling LLC
• Laura Nicole Oliveer
• Jessica L Oliveira, LMT
• Aleshia Oliver
• Brian W Oliver, NP-C
• Donna Michelle Oliver, MASSAGE THERAPIST
• Gretchen Oliver, MSW,CSW
• Hannah Rae Oliver, DMD, MS

• Occupational Therapist in Louisville, KY
• Providers in Louisville, KY by specialty
• Occupational Therapist in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 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.