Active NPI
John William Jennings, MBA, OTR/L
- Occupational Therapist
- Edmond, OK
National Provider Identifier
1902814742
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- OT569
- Practice address
- 2500 Old Farm LN
Edmond, OK 73013-6715 - Phone
- (405) 833-3951
- NPI assigned
- Aug 4, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | OT569 | OK | Primary |
Addresses
Primary practice location
2500 Old Farm LN
Edmond, OK 73013-6715
Mailing address
2500 Old Farm LN
Edmond, OK 73013-6715
Phone (405) 833-3951
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
- Credentials
- Master of Business Administration
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| OT569 | OK | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1154649600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1902814742",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2500 OLD FARM LN",
"city": "EDMOND",
"state": "OK",
"postal_code": "730136715",
"telephone_number": "405-833-3951"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2500 OLD FARM LN",
"city": "EDMOND",
"state": "OK",
"postal_code": "730136715",
"telephone_number": "405-833-3951"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JENNINGS",
"first_name": "JOHN",
"middle_name": "WILLIAM",
"name_prefix": "Mr.",
"credential": "MBA, OTR/L",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-08-04",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "OK",
"license": "OT569",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Edmond, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.