Provider Demographics
NPI:1306948625
Name:MCCARTNEY, JENNIFER PAYNE (PT, DPT)
Entity type:Individual
Prefix:MRS
First Name:JENNIFER
Middle Name:PAYNE
Last Name:MCCARTNEY
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:MISS
Other - First Name:JENNIFER
Other - Middle Name:JE
Other - Last Name:PAYNE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:9154 ESTATE THOMAS
Mailing Address - Street 2:
Mailing Address - City:ST THOMAS
Mailing Address - State:VI
Mailing Address - Zip Code:00802-2687
Mailing Address - Country:US
Mailing Address - Phone:340-776-7667
Mailing Address - Fax:340-714-1891
Practice Address - Street 1:9154 ESTATE THOMAS
Practice Address - Street 2:
Practice Address - City:ST THOMAS
Practice Address - State:VI
Practice Address - Zip Code:00802-2687
Practice Address - Country:US
Practice Address - Phone:340-776-7667
Practice Address - Fax:340-714-1891
Is Sole Proprietor?:No
Enumeration Date:2006-09-05
Last Update Date:2019-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY62027738225100000X
MA17664225100000X
VI145225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
VIBY438YMedicare PIN
MAY69899Medicare PIN