Provider Demographics
NPI:1184879793
Name:KEMP, JINGER F (OT)
Entity type:Individual
Prefix:
First Name:JINGER
Middle Name:F
Last Name:KEMP
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2515 DOUBLE CHURCHES RD
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:GA
Mailing Address - Zip Code:31909-2742
Mailing Address - Country:US
Mailing Address - Phone:706-660-5495
Mailing Address - Fax:796-660-5497
Practice Address - Street 1:2515 DOUBLE CHURCHES RD
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:GA
Practice Address - Zip Code:31909-2742
Practice Address - Country:US
Practice Address - Phone:706-660-5495
Practice Address - Fax:706-660-5497
Is Sole Proprietor?:No
Enumeration Date:2008-11-24
Last Update Date:2012-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAOT005267225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA1112KEOtherREGENCE
WA023490OtherDEPT OF L&I
WA1651KEOtherREGENCE
WA8949581OtherL&I CRIME VICTIMS
WA3600KEOtherREGENCE
WA5210KEOtherREGENCE
WA6981KEOtherREGENCE
WA8530651OtherDSHS
WAG8878052Medicare PIN