Active NPI
Jonathan M. Henry, OTR/L
- Occupational Therapist
- Buffalo, NY
National Provider Identifier
1952320319
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 011630-1
- Practice address
- 3495 Bailey Ave
Buffalo, NY 14215-1129 - Phone
- (716) 862-8568
- NPI assigned
- Jul 18, 2006
- Last updated
- Jul 8, 2007
- 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 | 011630-1 | NY | Primary |
Addresses
Primary practice location
3495 Bailey Ave
Buffalo, NY 14215-1129
Mailing address
16 Campus Dr Apt 3
Snyder, NY 14226-3704
Phone (716) 228-2260
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
| License | State | Type | Specialty |
|---|---|---|---|
| 011630-1 | NY | MD | Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153180800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1952320319",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "16 CAMPUS DR APT 3",
"city": "SNYDER",
"state": "NY",
"postal_code": "142263704",
"telephone_number": "716-228-2260"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3495 BAILEY AVE",
"city": "BUFFALO",
"state": "NY",
"postal_code": "142151129",
"telephone_number": "716-862-8568"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HENRY",
"first_name": "JONATHAN",
"middle_name": "M.",
"credential": "OTR/L",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-07-18",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "NY",
"license": "011630-1",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Buffalo, NY
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.