Active NPI
Jolene Sue Haworth, OTR
- Occupational Therapist
- Fort Sam Houston, TX
National Provider Identifier
1750562468
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 112306
- Practice address
- 3400 Roger Brooke Dr
Suite B
Fort Sam Houston, TX 78234-6315 - Phone
- (210) 916-1440
- NPI assigned
- Nov 21, 2007
- 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 |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 112306 | TX | Primary |
Addresses
Primary practice location
3400 Roger Brooke Dr
Suite B
Fort Sam Houston, TX 78234-6315
Mailing address
3400 Roger Brooke Dr
Suite B
Fort Sam Houston, TX 78234-6315
Phone (210) 916-1440
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 |
|---|---|---|---|
| 112306 | TX | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1195603200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1195603200000",
"number": "1750562468",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3400 ROGER BROOKE DR",
"address_2": "SUITE B",
"city": "FORT SAM HOUSTON",
"state": "TX",
"postal_code": "782346315",
"telephone_number": "210-916-1440"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3400 ROGER BROOKE DR",
"address_2": "SUITE B",
"city": "FORT SAM HOUSTON",
"state": "TX",
"postal_code": "782346315",
"telephone_number": "210-916-1440"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HAWORTH",
"first_name": "JOLENE",
"middle_name": "SUE",
"credential": "OTR",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-11-21",
"last_updated": "2007-11-21",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "TX",
"license": "112306",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fort Sam Houston, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.