Individual provider Active NPI

Jennifer M. Ehlin, MED. , C.O.T.A

  • Occupational Therapy Assistant
  • Saint John, IN
National Provider Identifier
1942524947
Registry record updated Mar 18, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Therapy AssistantTaxonomy code 224Z00000X
License
057000488 Issued in IL
Practice address
9426 Olcott Ave
Saint John, IN 46373-9562
Phone
(219) 365-5878
NPI assigned
Mar 18, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 18, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy Assistant 224Z00000X 057000488 IL Primary

Addresses

Primary practice location

9426 Olcott Ave
Saint John, IN 46373-9562

Mailing address

9426 Olcott Ave
Saint John, IN 46373-9562
Phone (219) 365-5878

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 Education

State licenses

LicenseStateTypeSpecialty
057000488ILMDOccupational Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1268870400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1268870400000",
    "number": "1942524947",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9426 OLCOTT AVE",
            "city": "SAINT JOHN",
            "state": "IN",
            "postal_code": "463739562",
            "telephone_number": "219-365-5878"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9426 OLCOTT AVE",
            "city": "SAINT JOHN",
            "state": "IN",
            "postal_code": "463739562",
            "telephone_number": "219-365-5878"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EHLIN",
        "first_name": "JENNIFER",
        "middle_name": "M.",
        "name_prefix": "Mrs.",
        "credential": "MED. , C.O.T.A",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-03-18",
        "last_updated": "2010-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "IL",
            "license": "057000488",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint John, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2010; 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.