Active NPI
Jennifer Jay
- Developmental Therapist
- Gainesville, FL
National Provider Identifier
1790335917
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Developmental Therapist
- Practice address
- 250 NW 76TH Dr
Gainesville, FL 32607-6668 - Phone
- (714) 809-6977
- NPI assigned
- Sep 19, 2019
- Last updated
- Jun 10, 2021
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Developmental Therapist | 222Q00000X | Primary | ||
| Behavior Technician | 106S00000X |
Addresses
Primary practice location
250 NW 76TH Dr
Gainesville, FL 32607-6668
Mailing address
10901 Brighton Bay Blvd NE Apt 5113
St Petersburg, FL 33716-3453
Phone (714) 809-6977
Other practice location 1
4020 SW 21st Rd
Gainesville, FL 32607-4340
Phone (714) 809-6977
Other practice location 2
4020 SW 21St Rd
Gainesville, FL 32607
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | Gainesville | Direct |
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1568851200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1623283200000",
"number": "1790335917",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10901 BRIGHTON BAY BLVD NE APT 5113",
"city": "ST PETERSBURG",
"state": "FL",
"postal_code": "337163453",
"telephone_number": "714-809-6977"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "250 NW 76TH DR",
"city": "GAINESVILLE",
"state": "FL",
"postal_code": "326076668",
"telephone_number": "714-809-6977"
}
],
"practiceLocations": [
{
"address_1": "4020 SW 21st Rd",
"address_purpose": "LOCATION",
"city": "Gainesville",
"state": "FL",
"postal_code": "326074340",
"country_code": "US",
"telephone_number": "714-809-6977",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "4020 SW 21ST RD",
"address_purpose": "LOCATION",
"city": "Gainesville",
"state": "FL",
"postal_code": "32607",
"country_code": "US",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "JAY",
"first_name": "JENNIFER",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-09-19",
"last_updated": "2021-06-10",
"certification_date": "2021-06-10",
"status": "A"
},
"taxonomies": [
{
"code": "222Q00000X",
"taxonomy_group": "",
"desc": "Developmental Therapist",
"state": null,
"license": null,
"primary": true
},
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "CONNECT",
"endpointTypeDescription": "CONNECT URL",
"endpoint": "Gainesville",
"affiliation": "N",
"use": "DIRECT",
"useDescription": "Direct",
"address_1": "4020 SW 21st Rd",
"city": "Gainesville",
"state": "FL",
"country_code": "US",
"postal_code": "326074340",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Gainesville, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.