Kimberly Rousseau-Simmons, OT

Individual provider Active NPI Occupational Therapist · Berthoud, CO

NPI 1013751700 · NPPES record last updated Jun 19, 2024

Key facts

NPI
1013751700
Entity type
Individual (NPI type 1)
Primary specialty
Occupational Therapist 225X00000X
License
0007752 (CO)
Practice address
3400 Woodcock St Apt K1
Berthoud, CO 80513-7026
Phone
(636) 541-0986
NPI assigned
Jun 19, 2024
Sex
Female
Sole proprietor
Yes

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare Care Compare profile

Specialty
Occupational Therapist in Private Practice
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Prestige Rehab Colorado (12 clinicians)

Practice addresses (Care Compare)

2020 N Academy Blvd
Suite 261
Colorado Springs, CO 80909-1567
Phone (908) 670-7573

Medicare participation

Medicare fee-for-service enrollment
Enrolled in CO

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20240912003148 CO Practitioner - Occupational Therapist in Private Practice 8022558360 Reassigns benefits to 2 organizations

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
0007752COMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Prestige Rehab LLC Occupational Therapist Current
since Jun 30, 2024
Accepting new patients
Prestige Rehab Colorado Occupational Therapist Current
since Sep 25, 2024
Accepting new patients

Locations

2020 N Academy Blvd
Ste 261
Colorado Springs, CO 80909
Phone (719) 232-5591

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 0007752 CO Yes

Addresses

Primary practice location

3400 Woodcock St Apt K1
Berthoud, CO 80513-7026

Mailing address

3400 Woodcock St Apt K1
Berthoud, CO 80513-7026
Phone (636) 541-0986

Other providers in Berthoud, CO

All providers in Berthoud, CO · Occupational Therapist in Colorado

Sources for this page

Verify at the official NPI Registry.