Active NPI
Kimberly Hickman, MS, OTR/L
- Occupational Therapist
- Audubon, PA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- OC011276
- Practice address
- 10000 Shannondell Dr
Audubon, PA 19403-5615 - Phone
- (610) 382-8710
- NPI assigned
- May 12, 2015
- Last updated
- May 12, 2015
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | OC011276 | PA | Primary |
Addresses
Primary practice location
10000 Shannondell Dr
Audubon, PA 19403-5615
Mailing address
18 S Malin Rd
Broomall, PA 19008-1801
Phone (610) 416-0199
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in PA
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Occupational Therapist in Private Practice
- Education
- Other, 2009
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
10000 Shannondell Dr
Audubon, PA 19403-5615
Phone (610) 728-5236
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Master of Science
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Shannondell, Inc. | Current | Accepting new patients | |
| Shannondell, Inc. | Current | Accepting new patients | |
| Shannondell Inc. | Current | Accepting new patients |
Locations
10000 Shannondell Dr
Norristown, PA 19403
Phone (610) 728-5236
5000 Shannondell Dr
Norristown, PA 19403
Phone (610) 664-2295
Organizations & group practices 3
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba Shannondell Medical Group
- Primary Care Clinic/Center
- Audubon, PA
- NPI 1225825342
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1431388800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1431388800000",
"number": "1043698947",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "18 S MALIN RD",
"city": "BROOMALL",
"state": "PA",
"postal_code": "190081801",
"telephone_number": "610-416-0199"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10000 SHANNONDELL DR",
"city": "AUDUBON",
"state": "PA",
"postal_code": "194035615",
"telephone_number": "610-382-8710"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HICKMAN",
"first_name": "KIMBERLY",
"name_prefix": "Mrs.",
"credential": "MS, OTR/L",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-05-12",
"last_updated": "2015-05-12",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "PA",
"license": "OC011276",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Audubon, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.