Individual provider Active NPI

Jenna Chafin

  • Occupational Therapist
  • Johnson City, TN
National Provider Identifier
1902328339
Registry record updated Sep 12, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
5604 Issued in TN
Practice address
2214 E Fairview Ave
Johnson City, TN 37601-2860
Phone
(423) 928-6464
NPI assigned
Jul 7, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 12, 2023

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 5604 TN Primary

Addresses

Primary practice location

2214 E Fairview Ave
Johnson City, TN 37601-2860

Mailing address

2214 E Fairview Ave
Johnson City, TN 37601-2860

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

State licenses

LicenseStateTypeSpecialty
5604TNMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Mini Miracles Pediatric Therapy, PLLC CurrentSince Oct 8, 2023 Accepting new patients
Fairview Therapy Occupational Therapist CurrentSince Sep 17, 2023 Accepting new patients

Locations

109 Meadow View Rd
Ste 6
Bristol, TN 37620

631 Sinasta Dr
Ste 4
Erwin, TN 37650
Phone (423) 220-3317

2214 E Fairview Ave
Johnson City, TN 37601
Phone (423) 928-6464

Organizations & group practices 2

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": "1499385600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694476800000",
    "number": "1902328339",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2214 E FAIRVIEW AVE",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376012860"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2214 E FAIRVIEW AVE",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376012860",
            "telephone_number": "423-928-6464"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHAFIN",
        "first_name": "JENNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-07-07",
        "last_updated": "2023-09-12",
        "certification_date": "2023-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "TN",
            "license": "5604",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Johnson City, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2023; 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.