Jennifer Peterson Poe

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

OT16235 Issued in FL

Practice address

3837 Cardinal Oaks Cir
Orange Park, FL 32065-4251

Phone

(607) 339-6652

NPI assigned

Aug 13, 2009

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Bright Spark Therapy

  • Speech-Language Pathologist
  • Orange Park, FL
  • NPI 1104567494

  Occupational Therapist

  NPD (past)

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

{
    "created_epoch": "1250121600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708560000000",
    "number": "1992937650",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3837 CARDINAL OAKS CIR",
            "city": "ORANGE PARK",
            "state": "FL",
            "postal_code": "320654251",
            "telephone_number": "607-339-6652"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3837 CARDINAL OAKS CIR",
            "city": "ORANGE PARK",
            "state": "FL",
            "postal_code": "320654251",
            "telephone_number": "607-339-6652"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "109 Tudor Rd",
            "address_purpose": "LOCATION",
            "city": "Ithaca",
            "state": "NY",
            "postal_code": "148506327",
            "country_code": "US",
            "telephone_number": "607-277-0457",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "POE",
        "first_name": "JENNIFER",
        "middle_name": "PETERSON",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-08-13",
        "last_updated": "2024-02-22",
        "certification_date": "2024-02-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "222Q00000X",
            "taxonomy_group": "",
            "desc": "Developmental Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "FL",
            "license": "OT16239",
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "FL",
            "license": "OT16235",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE NUMBER",
            "identifier": "OT16239",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jade L Pizarro, MD
• Aaron John Plotz
• Jacob Plotz, D.C.
• Podiatry Associates of Florida Inc
• Podiatry Associates of Florida Inc
• Pointe Med Pharmacy, Inc.
• Pointe Medical Services Inc
• Shradha Pokharel, MD
• Alysha Marie Polk
• Polly W. Peterson, PH.D.

• Occupational Therapist in Orange Park, FL
• Providers in Orange Park, FL by specialty
• Occupational Therapist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 2024; 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.