Nicole Fox Jennette, OTR/L

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

14109 Issued in NC

Practice address

1304 SE Second St
Snow Hill, NC 28580-2014

Phone

(252) 747-8126

NPI assigned

Jun 1, 2022

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NC

Enrollment records 1

Specialty

Occupational Therapist in Private Practice

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Paragon Outpatient Rehabilitation Services LLCGroup PAC ID 8022272848, 199 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Paragon Outpatient Rehabilitation Services, LLC

  • Rehabilitation Clinic/Center
  • Louisville, KY
  • NPI 1871867325

  NC

  Medicare reassignment Care Compare group NPD
• Paragon Outpatient Rehabilitation Services, LLC

  • Rehabilitation Clinic/Center
  • Roxboro, NC
  • NPI 1245014380
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1654041600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654041600000",
    "number": "1831838481",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "214 SE FOURTH ST",
            "city": "SNOW HILL",
            "state": "NC",
            "postal_code": "285801526",
            "telephone_number": "828-773-3588"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1304 SE SECOND ST",
            "city": "SNOW HILL",
            "state": "NC",
            "postal_code": "285802014",
            "telephone_number": "252-747-8126"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JENNETTE",
        "first_name": "NICOLE",
        "middle_name": "FOX",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-06-01",
        "last_updated": "2022-06-01",
        "certification_date": "2022-06-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NC",
            "license": "14109",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NORTH CAROLINA BOARD OF OCCUPATIONAL THERAPY",
            "identifier": "14109",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Chelsea Brynn Hurley, NP
• Badr Mostafa Ibrahim, RPH
• Anna Lorraine Imhoff, M.D.
• Jennah-Li Eulalia Jackson, DMD
• Bonita B Jenkins, MSW, LCSWA
• Kristen Fischer Jilg, D.M.D.
• Ashley Paige Johnson, LMFT
• Thelma R Johnson
• Chrislyn Jones
• Maya Kahwagi, MD

• Occupational Therapist in Snow Hill, NC
• Providers in Snow Hill, NC by specialty
• Occupational Therapist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 2022; 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.