Individual provider Active NPI

Jennifer Marseglia, COTA/L

  • Community Health Worker
  • Vail, AZ
National Provider Identifier
1922409440
Registry record updated Sep 16, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Health WorkerTaxonomy code 172V00000X
License
3847 Issued in AZ
Practice address
13801 E Benson Hwy
Vail, AZ 85641-9074
Phone
(520) 879-2000
NPI assigned
Sep 16, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 16, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community Health Worker 172V00000X 3847 AZ Primary

Addresses

Primary practice location

13801 E Benson Hwy
Vail, AZ 85641-9074

Mailing address

6591 E Splendid LN
Tucson, AZ 85756-8460
Phone (520) 668-3217

Other names 1

  • Miss Jennifer Sue Brandt Former name

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

State licenses

LicenseStateTypeSpecialty
3847AZMDCommunity Health Worker

NPI Registry JSON

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

{
    "created_epoch": "1410825600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1410825600000",
    "number": "1922409440",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6591 E SPLENDID LN",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857568460",
            "telephone_number": "520-668-3217"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13801 E BENSON HWY",
            "city": "VAIL",
            "state": "AZ",
            "postal_code": "856419074",
            "telephone_number": "520-879-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARSEGLIA",
        "first_name": "JENNIFER",
        "name_prefix": "Mrs.",
        "credential": "COTA/L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-09-16",
        "last_updated": "2014-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "172V00000X",
            "taxonomy_group": "",
            "desc": "Community Health Worker",
            "state": "AZ",
            "license": "3847",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNIFER",
            "last_name": "BRANDT",
            "middle_name": "SUE",
            "prefix": "MISS",
            "credential": "COTA/L",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Vail, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2014; 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.