Individual provider Active NPI

Jennifer Kwiatkowski, OTR/L

  • Occupational Therapist
  • Wernersville, PA
National Provider Identifier
1972903029
Registry record updated Aug 26, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
OC005605L Issued in PA
Practice address
1 Heidelberg Dr
Wernersville, PA 19565-1642
Phone
(610) 927-8160
NPI assigned
Aug 26, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 26, 2014

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 OC005605L PA Primary

Addresses

Primary practice location

1 Heidelberg Dr
Wernersville, PA 19565-1642

Mailing address

2428 Fairview St
West Lawn, PA 19609-1317
Phone (610) 301-3043

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20151123002338 PA Practitioner - Occupational Therapist in Private Practice 9335449313 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Phoebe Corporate & Community Based Services CurrentSince Aug 1, 2015 Accepting new patients
Phoebe Corporate and Community Based Services Inc CurrentSince Aug 1, 2015 Accepting new patients

Locations

1925 W Turner St
Allentown, PA 18104
Phone (610) 794-5075

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Phoebe BerksWernersville, PA, CCN 395880 Skilled nursing facility Operational/Managerial Control
Adp of the SNF
Jul 3, 2022
Jul 3, 2022

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

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": "1409011200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1409011200000",
    "number": "1972903029",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2428 FAIRVIEW ST",
            "city": "WEST LAWN",
            "state": "PA",
            "postal_code": "196091317",
            "telephone_number": "610-301-3043"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 HEIDELBERG DR",
            "city": "WERNERSVILLE",
            "state": "PA",
            "postal_code": "195651642",
            "telephone_number": "610-927-8160"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KWIATKOWSKI",
        "first_name": "JENNIFER",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-08-26",
        "last_updated": "2014-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "PA",
            "license": "OC005605L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wernersville, PA

Sources for this page

Verify at the official NPI Registry.