Individual provider Active NPI

Jennifer L Stornelli, OTR/L

  • Occupational Therapist
  • Waltham, MA
National Provider Identifier
1801079132
Registry record updated Dec 10, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
8549 Issued in MA
Practice address
411 Waverley Oaks Rd
Building #3, Suite 305
Waltham, MA 02452-8448
Phone
(781) 894-6564
NPI assigned
Dec 10, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 10, 2007

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 8549 MA Primary

Addresses

Primary practice location

411 Waverley Oaks Rd
Building #3, Suite 305
Waltham, MA 02452-8448

Mailing address

411 Waverley Oaks Rd
Building #3, Suite 305
Waltham, MA 02452-8448
Phone (781) 894-6564

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": "1197244800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1197244800000",
    "number": "1801079132",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "411 WAVERLEY OAKS RD",
            "address_2": "BUILDING #3, SUITE 305",
            "city": "WALTHAM",
            "state": "MA",
            "postal_code": "024528448",
            "telephone_number": "781-894-6564"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "411 WAVERLEY OAKS RD",
            "address_2": "BUILDING #3, SUITE 305",
            "city": "WALTHAM",
            "state": "MA",
            "postal_code": "024528448",
            "telephone_number": "781-894-6564"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STORNELLI",
        "first_name": "JENNIFER",
        "middle_name": "L",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-12-10",
        "last_updated": "2007-12-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "MA",
            "license": "8549",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waltham, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.