Active NPI
Jennifer Bauchmann Betancourt, OTA
- Health & Wellness Coach
- Altamont, NY
National Provider Identifier
1790917367
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Health & Wellness Coach
- Practice address
- 140 Lincoln Ave
Altamont, NY 12009-5326 - Phone
- (518) 861-3601
- NPI assigned
- Aug 17, 2009
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Health & Wellness Coach | 171400000X | Primary | ||
| Occupational Therapy Assistant | 224Z00000X | 007349-1 | NY |
Addresses
Primary practice location
140 Lincoln Ave
Altamont, NY 12009-5326
Mailing address
140 Lincoln Ave
Altamont, NY 12009-5326
Phone (518) 861-3601
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 007349-1 | NY | MD | Occupational Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1250467200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1732579200000",
"number": "1790917367",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "140 LINCOLN AVE",
"city": "ALTAMONT",
"state": "NY",
"postal_code": "120095326",
"telephone_number": "518-861-3601"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "140 LINCOLN AVE",
"city": "ALTAMONT",
"state": "NY",
"postal_code": "120095326",
"telephone_number": "518-861-3601"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BETANCOURT",
"first_name": "JENNIFER",
"middle_name": "BAUCHMANN",
"credential": "OTA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2009-08-17",
"last_updated": "2024-11-26",
"certification_date": "2024-11-26",
"status": "A"
},
"taxonomies": [
{
"code": "171400000X",
"taxonomy_group": "",
"desc": "Health & Wellness Coach",
"state": null,
"license": null,
"primary": true
},
{
"code": "224Z00000X",
"taxonomy_group": "",
"desc": "Occupational Therapy Assistant",
"state": "NY",
"license": "007349-1",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Altamont, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 26, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.