Provider Demographics
NPI:1689786766
Name:SEXTON, JENNIFER Y (OTR/L, CHT)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:Y
Last Name:SEXTON
Suffix:
Gender:F
Credentials:OTR/L, CHT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 38008
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27438-8008
Mailing Address - Country:US
Mailing Address - Phone:336-545-5000
Mailing Address - Fax:336-545-5020
Practice Address - Street 1:3200 NORTHLINE AVE
Practice Address - Street 2:STE 160
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27408-7616
Practice Address - Country:US
Practice Address - Phone:336-545-5000
Practice Address - Fax:336-545-5020
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2011-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC3871225X00000X
NC1027736225XH1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
No225XH1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistHand
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC5174990001OtherPALMETTO
NC6400692OtherUNITED HEALTHCARE
NC7301661Medicaid
NCD3989OtherMEDCOST
NC9332719OtherPHCS
NC13377OtherBCBS
NC3530063OtherAETNA
NC2338738Medicare ID - Type Unspecified
NC13377OtherBCBS