Jeanne Anderson, OTR

Individual provider Active NPI Occupational Therapist · Homer, AK

NPI 1861799124 · NPPES record last updated Dec 27, 2018

Key facts

NPI
1861799124
Entity type
Individual (NPI type 1)
Primary specialty
Occupational Therapist 225X00000X
License
PHYO2665 (AK)
Practice address
59976 Tern CT
Homer, AK 99603-9434
Phone
(570) 977-1800
NPI assigned
Feb 23, 2011
Sex
Female
Sole proprietor
Yes

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.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
PHYO2665AKMDOccupational Therapist
46TR00541300NJMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
K-Bay Kids LLC Single Specialty Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist
Group: 193400000X SINGLE SPECIALTY GROUP
225X00000X PHYO2665 AK Yes
Occupational Therapist 225X00000X 46TR00541300 NJ

Addresses

Primary practice location

59976 Tern CT
Homer, AK 99603-9434

Mailing address

59976 Tern CT
Homer, AK 99603-9434
Phone (570) 977-1800

Other practice location 1

3575 Quakerbridge Rd
Hamilton, NJ 08619-1205
Phone (609) 631-2800

Other providers in Homer, AK

All providers in Homer, AK · Occupational Therapist in Alaska

Sources for this page

Verify at the official NPI Registry.