Individual provider Active NPI

Jenna Fellows, OTR/L

  • Physical Rehabilitation Occupational Therapist
  • Baltimore, MD
National Provider Identifier
1891139838
Registry record updated Mar 16, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Rehabilitation Occupational TherapistTaxonomy code 225XP0019X
License
06608 Issued in MD
Practice address
8710 Emge Rd
Baltimore, MD 21234-3504
Phone
(410) 810-2448
NPI assigned
Apr 22, 2013
Last updated
Mar 16, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 16, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Rehabilitation Occupational Therapist 225XP0019X 06608 MD Primary

Addresses

Primary practice location

8710 Emge Rd
Baltimore, MD 21234-3504

Mailing address

147 Attenborough Dr
Apt. 302
Baltimore, MD 21237-4999
Phone (301) 471-1961

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230420001286 MD Practitioner - Occupational Therapist in Private Practice 5092170324 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Fox Rehab OT MD LLCGroup PAC ID 4981847977, 60 clinicians

Practice addresses (Care Compare)

11665 Doolittle Dr
Waldorf, MD 20602-2898
Phone (877) 407-3422

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Fox Rehab OT MD LLC CurrentSince Mar 1, 2023 Accepting new patients

Locations

11665 Doolittle Dr
Waldorf, MD 20602
Phone (301) 638-4100

7 Carnegie Plz
Cherry Hill, NJ 08003

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1366588800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678924800000",
    "number": "1891139838",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "147 ATTENBOROUGH DR",
            "address_2": "APT. 302",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212374999",
            "telephone_number": "301-471-1961"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8710 EMGE RD",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212343504",
            "telephone_number": "410-810-2448"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FELLOWS",
        "first_name": "JENNA",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-04-22",
        "last_updated": "2023-03-16",
        "certification_date": "2023-03-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XP0019X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Physical Rehabilitation",
            "state": "MD",
            "license": "06608",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 2023; 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.