Individual provider Active NPI

Jennifer Renee Estrada Warren, COTA/L

  • Occupational Therapy Assistant
  • Bluffton, SC
National Provider Identifier
1861637886
Registry record updated May 24, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Therapy AssistantTaxonomy code 224Z00000X
License
OTA10744 Issued in FL
Practice address
4 Oliver CT Ste 105
Bluffton, SC 29910-8708
Phone
(843) 706-9367
NPI assigned
Dec 4, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 24, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy Assistant 224Z00000X OTA10744 FL Primary

Addresses

Primary practice location

4 Oliver CT Ste 105
Bluffton, SC 29910-8708

Mailing address

4 Oliver CT Ste 105
Bluffton, SC 29910-8708
Phone (843) 706-9367

Other practice location 1

2810 Ruleme St
Attn: Rehab
Eustis, FL 32726-6527
Phone (352) 357-1990

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

LicenseStateTypeSpecialty
OTA10744FLMDOccupational Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1228348800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1621814400000",
    "number": "1861637886",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4 OLIVER CT STE 105",
            "city": "BLUFFTON",
            "state": "SC",
            "postal_code": "299108708",
            "telephone_number": "843-706-9367"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4 OLIVER CT STE 105",
            "city": "BLUFFTON",
            "state": "SC",
            "postal_code": "299108708",
            "telephone_number": "843-706-9367"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2810 Ruleme St",
            "address_2": "Attn: Rehab",
            "address_purpose": "LOCATION",
            "city": "Eustis",
            "state": "FL",
            "postal_code": "327266527",
            "country_code": "US",
            "telephone_number": "352-357-1990",
            "fax_number": "352-357-3716",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ESTRADA WARREN",
        "first_name": "JENNIFER",
        "middle_name": "RENEE",
        "credential": "COTA/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-12-04",
        "last_updated": "2021-05-24",
        "certification_date": "2021-05-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "FL",
            "license": "OTA10744",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bluffton, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 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.

Verify at the official NPI Registry.