MEDICARE: JENNA MARIE FLEMING MOT, OTR

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225X00000X	Occupational Therapist	31006592A	IN
2	225X00000X	Occupational Therapist	OT013548	OH

General Provider Information

NPI Number	:	1831686138
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JENNA MARIE FLEMING MOT, OTR

Provider Business Mailing Address
First Line	:	1200 S CLINTON ST
Second Line	:
City	:	FORT WAYNE
State	:	IN
Zip	:	46802-3594
Country	:	US
Telephone Number	:	260-467-1000
Fax Number	:

Provider Business Practice Location Address
First Line	:	1200 S CLINTON ST
Second Line	:
City	:	FORT WAYNE
State	:	IN
Zip	:	46802-3594
Country	:	US
Telephone Number	:	260-467-1000
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/23/2018
Last Update Date	:	12/17/2025

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