Kimberly Jo Valencia, OTR/L

Primary specialty

Gerontology Occupational TherapistTaxonomy code 225XG0600X

License

5201007153 Issued in MI

Practice address

101 E State St
Kennett Square, PA 19348-3109

Phone

(610) 925-2123

NPI assigned

May 13, 2011

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other names 1

• Ms. Kimberly Jo Pake Former name

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Tmi East, Inc.

  dba Everactive Therapy

  • Rehabilitation Clinic/Center
  • Saginaw, MI
  • NPI 1336709252
  Medicare reassignment NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1305244800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1305244800000",
    "number": "1033401757",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "206 E FULTON ST",
            "city": "BAY CITY",
            "state": "MI",
            "postal_code": "487063626",
            "telephone_number": "989-391-9707"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 E STATE ST",
            "city": "KENNETT SQUARE",
            "state": "PA",
            "postal_code": "193483109",
            "telephone_number": "610-925-2123"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VALENCIA",
        "first_name": "KIMBERLY",
        "middle_name": "JO",
        "name_prefix": "Mrs.",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-05-13",
        "last_updated": "2011-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XG0600X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Gerontology",
            "state": "MI",
            "license": "5201007153",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KIMBERLY",
            "last_name": "PAKE",
            "middle_name": "JO",
            "prefix": "MS.",
            "credential": "OTR/L",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Adrian Twigg, PTA
• Hassel A Twigg, PTA
• Stacy Underwood, MS CCC-SLP
• Unionville-Chadds Ford School District
• Karen A Vaile, SLP, CCC
• James Michael Valentino
• Susan E. Vanore
• Jennifer Vattimo, R.D.
• Alma Chicote Vertudazo, OTR
• Tanya Marie Vigdal, OD

• Gerontology Occupational Therapist in Kennett Square, PA
• Providers in Kennett Square, PA by specialty
• Gerontology Occupational Therapist in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.