Individual provider Active NPI

Jennifer Marie Buckley, MS OTR/L

  • Occupational Therapist
  • Kihei, HI
National Provider Identifier
1891258117
Registry record updated Mar 29, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
13141 Issued in MA
Practice address
1300 N Holopono St Ste 108
Kihei, HI 96753-6946
Phone
(781) 424-4120
NPI assigned
Apr 12, 2019
Last updated
Mar 29, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 29, 2025

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 13141 MA Primary

Addresses

Primary practice location

1300 N Holopono St Ste 108
Kihei, HI 96753-6946

Mailing address

2136 Konou PL Apt 105
Kihei, HI 96753-8776
Phone (781) 424-4120

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)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
13141MAMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Transforming Tomorrows CurrentSince Mar 30, 2025 Accepting new patients

Locations

1300 N Holopono St
Ste 108
Kihei, HI 96753
Phone (808) 206-9371

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": "1555027200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743206400000",
    "number": "1891258117",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2136 KONOU PL APT 105",
            "city": "KIHEI",
            "state": "HI",
            "postal_code": "967538776",
            "telephone_number": "781-424-4120"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1300 N HOLOPONO ST STE 108",
            "city": "KIHEI",
            "state": "HI",
            "postal_code": "967536946",
            "telephone_number": "781-424-4120"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUCKLEY",
        "first_name": "JENNIFER",
        "middle_name": "MARIE",
        "credential": "MS OTR/L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-04-12",
        "last_updated": "2025-03-29",
        "certification_date": "2025-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "MA",
            "license": "13141",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kihei, HI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2025; 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.