Individual provider Active NPI

Jessica Elizabeth Renken, OTD

  • Occupational Therapist
  • Fuquay Varina, NC
National Provider Identifier
1861366569
Registry record updated Jun 9, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
18064 Issued in NC
Practice address
7608 Purfoy Rd
Fuquay Varina, NC 27526-8930
Phone
(919) 220-5255
Fax
(919) 552-0015
NPI assigned
Oct 3, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 9, 2026

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 18064 NC Primary

Addresses

Primary practice location

7608 Purfoy Rd
Fuquay Varina, NC 27526-8930

Mailing address

PO Box 5105
Belfast, ME 04915-5100
Phone (919) 220-5255

Other practice location 1

150 Francam Dr # 124
Fayetteville, NC 28311-4500
Phone (910) 229-3924

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20251106000169 NC Practitioner - Occupational Therapist in Private Practice 3870083025 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 2025
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

120 William Penn PLZ
Durham, NC 27704-2150

PO Box
Belfast, ME 04915

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
18064NCMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Inner Coastal Plain - PT, LLC Occupational Therapist CurrentSince Oct 15, 2025 Accepting new patients

Locations

150 Francam Dr
Ste 124
Fayetteville, NC 28311
Phone (910) 229-3924

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1759449600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1780963200000",
    "number": "1861366569",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5105",
            "city": "BELFAST",
            "state": "ME",
            "postal_code": "049155100",
            "telephone_number": "919-220-5255",
            "fax_number": "919-552-0015"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7608 PURFOY RD",
            "city": "FUQUAY VARINA",
            "state": "NC",
            "postal_code": "275268930",
            "telephone_number": "919-220-5255",
            "fax_number": "919-552-0015"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "150 Francam Dr # 124",
            "address_purpose": "LOCATION",
            "city": "Fayetteville",
            "state": "NC",
            "postal_code": "283114500",
            "country_code": "US",
            "telephone_number": "910-229-3924",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RENKEN",
        "first_name": "JESSICA",
        "middle_name": "ELIZABETH",
        "credential": "OTD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-10-03",
        "last_updated": "2026-06-09",
        "certification_date": "2026-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NC",
            "license": "18064",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fuquay Varina, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2026; 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.