Individual provider Active NPI

Jennifer Eliza Renker, OTR/L

  • Occupational Therapist
  • Ossian, IN
National Provider Identifier
1780108142
Registry record updated Jul 27, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
021619-1 Issued in NY
Practice address
3900 E 900 N
Ossian, IN 46777-9253
Phone
(260) 241-7887
NPI assigned
Jul 27, 2017
Last updated
Jul 27, 2017By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 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 021619-1 NY Primary

Addresses

Primary practice location

3900 E 900 N
Ossian, IN 46777-9253

Mailing address

3900 E 900 N
Ossian, IN 46777-9253
Phone (260) 241-7887

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230109002844 MA Practitioner - Occupational Therapist in Private Practice 4981074994 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

25 Cobb St
Mansfield, MA 02048-4505
Phone (508) 471-5392

86 Saunders Rd
Norwood, MA 02062-3242
Phone (781) 285-7950

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
021619-1NYMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Healthpro Heritage Rehab & Fitness, LLC Occupational Therapist CurrentSince Oct 30, 2022 Accepting new patients
Healthpro Heritage Rehab & Fitness, LLC Occupational Therapist CurrentSince Oct 30, 2022 Accepting new patients

Organizations & group practices 2

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": "1501113600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1501113600000",
    "number": "1780108142",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3900 E 900 N",
            "city": "OSSIAN",
            "state": "IN",
            "postal_code": "467779253",
            "telephone_number": "260-241-7887"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3900 E 900 N",
            "city": "OSSIAN",
            "state": "IN",
            "postal_code": "467779253",
            "telephone_number": "260-241-7887"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RENKER",
        "first_name": "JENNIFER",
        "middle_name": "ELIZA",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-07-27",
        "last_updated": "2017-07-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NY",
            "license": "021619-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ossian, IN

Sources for this page

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