Healthcare Provider Details

I. General information

NPI: 1760305502
Provider Name (Legal Business Name): JENNIFER L CARTER OTR, CLT, CHT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/30/2026
Last Update Date: 07/30/2026
Certification Date: 07/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5721 W 119TH ST
OVERLAND PARK KS
66209-3722
US

IV. Provider business mailing address

2304 NW FRANCES ST
LEES SUMMIT MO
64081-2045
US

V. Phone/Fax

Practice location:
  • Phone: 913-498-6000
  • Fax:
Mailing address:
  • Phone: 816-810-1856
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225XH1200X
TaxonomyHand Occupational Therapist
License Number17-01578
License Number StateKS
# 2
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number2000153609
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: