Individual provider Active NPI

Jenna Lynn

  • Day Training/Habilitation Specialist
  • Jonesboro, AR
National Provider Identifier
1750663670
Registry record updated Sep 16, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Day Training/Habilitation SpecialistTaxonomy code 373H00000X
Practice address
1900 Stillwater Dr
Jonesboro, AR 72404-9119
Phone
(870) 932-3600
NPI assigned
Sep 16, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 16, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Day Training/Habilitation Specialist 373H00000X Primary

Addresses

Primary practice location

1900 Stillwater Dr
Jonesboro, AR 72404-9119

Mailing address

1900 Stillwater Dr
Jonesboro, AR 72404-9119
Phone (870) 932-3600

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240807001275 TN Practitioner - Occupational Therapist in Private Practice 9739626813 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
State of TennesseeGroup PAC ID 5698687077, 21 clinicians

Practice addresses (Care Compare)

11437 Milton Wilson Rd
Arlington, TN 38002-4926
Phone (901) 745-7509

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6763TNMDPhysical Therapist

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1316131200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1316131200000",
    "number": "1750663670",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1900 STILLWATER DR",
            "city": "JONESBORO",
            "state": "AR",
            "postal_code": "724049119",
            "telephone_number": "870-932-3600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1900 STILLWATER DR",
            "city": "JONESBORO",
            "state": "AR",
            "postal_code": "724049119",
            "telephone_number": "870-932-3600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LYNN",
        "first_name": "JENNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-09-16",
        "last_updated": "2011-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "373H00000X",
            "taxonomy_group": "",
            "desc": "Day Training/Habilitation Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jonesboro, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2011; 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.