Individual provider Active NPI

Catlin Jensen

  • Occupational Therapist
  • Eagle, ID
National Provider Identifier
1760996912
Registry record updated Nov 27, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
Practice address
449 S Fitness PL
Eagle, ID 83616-6828
Phone
(208) 957-6301
NPI assigned
Nov 27, 2017
Last updated
Nov 27, 2017By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 27, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X Primary

Addresses

Primary practice location

449 S Fitness PL
Eagle, ID 83616-6828

Mailing address

449 S Fitness PL
Eagle, ID 83616-6828

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220425000307 ID Practitioner - Occupational Therapist in Private Practice 7113313420 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Adventure Pediatric Therapy LLC CurrentSince Mar 14, 2022 Accepting new patients
OT 4 Kidz, Inc Occupational Therapist PastSince Sep 6, 2020 Accepting new patients
OT 4 Kidz, Inc PastSince Mar 20, 2022 Accepting new patients

Locations

1115 N Garden St
Boise, ID 83706
Phone (208) 495-7615

770 S 13th St
Unit 6606
Boise, ID 83707

Organizations & group practices 3

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

NPI Registry JSON

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

{
    "created_epoch": "1511740800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1511740800000",
    "number": "1760996912",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "449 S FITNESS PL",
            "city": "EAGLE",
            "state": "ID",
            "postal_code": "836166828"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "449 S FITNESS PL",
            "city": "EAGLE",
            "state": "ID",
            "postal_code": "836166828",
            "telephone_number": "208-957-6301"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JENSEN",
        "first_name": "CATLIN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-11-27",
        "last_updated": "2017-11-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Eagle, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.