Active NPI
Jill Suzanne Jensen, OTR/L
- Occupational Therapist
- Gulf Shores, AL
National Provider Identifier
1770933566
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- OT4017
- Practice address
- 4170 Spinnaker Dr
Apt 506
Gulf Shores, AL 36542-2957 - Phone
- (417) 619-6105
- NPI assigned
- Jun 13, 2016
- 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 | OT4017 | AL | Primary |
Addresses
Primary practice location
4170 Spinnaker Dr
Apt 506
Gulf Shores, AL 36542-2957
Mailing address
4170 Spinnaker Dr
Apt 506
Gulf Shores, AL 36542-2957
Phone (417) 619-6105
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)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1465776000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1465776000000",
"number": "1770933566",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4170 SPINNAKER DR",
"address_2": "APT 506",
"city": "GULF SHORES",
"state": "AL",
"postal_code": "365422957",
"telephone_number": "417-619-6105"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4170 SPINNAKER DR",
"address_2": "APT 506",
"city": "GULF SHORES",
"state": "AL",
"postal_code": "365422957",
"telephone_number": "417-619-6105"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JENSEN",
"first_name": "JILL",
"middle_name": "SUZANNE",
"name_prefix": "Miss",
"credential": "OTR/L",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2016-06-13",
"last_updated": "2016-06-13",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "AL",
"license": "OT4017",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Gulf Shores, AL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.