Individual provider Active NPI

Kimberleigh Moon Rohland

  • Developmental Therapist
  • Lunenburg, MA
National Provider Identifier
1073167219
Registry record updated Feb 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Developmental TherapistTaxonomy code 222Q00000X
Practice address
132 Robbs Hill Rd
Lunenburg, MA 01462-2167
Phone
(860) 351-5407
NPI assigned
Jul 26, 2019
Last updated
Feb 3, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 3, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Developmental Therapist 222Q00000X NU Primary

Addresses

Primary practice location

132 Robbs Hill Rd
Lunenburg, MA 01462-2167

Mailing address

45 Whitford Cir
Marshfield, MA 02050-4147
Phone (781) 812-3111

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20251224002374 MA Practitioner - Clinical Social Worker 4789179979 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2022
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1340 Boylston St
Boston, MA 02215-4302

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Fenway Community Health Center, Inc CurrentSince Sep 13, 2025 Accepting new patients
Fenway Community Health Center, Inc CurrentSince Sep 13, 2025 Accepting new patients
Innovative Autism Connections, LLC CurrentSince Aug 6, 2019 Accepting new patients

Locations

1340 Boylston St
Boston, MA 02215
Phone (617) 247-7555

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.

NPI Registry JSON

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

{
    "created_epoch": "1564099200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706918400000",
    "number": "1073167219",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "45 WHITFORD CIR",
            "city": "MARSHFIELD",
            "state": "MA",
            "postal_code": "020504147",
            "telephone_number": "781-812-3111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "132 ROBBS HILL RD",
            "city": "LUNENBURG",
            "state": "MA",
            "postal_code": "014622167",
            "telephone_number": "860-351-5407"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROHLAND",
        "first_name": "KIMBERLEIGH",
        "middle_name": "MOON",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-07-26",
        "last_updated": "2024-02-03",
        "certification_date": "2024-02-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "222Q00000X",
            "taxonomy_group": "",
            "desc": "Developmental Therapist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lunenburg, MA

Sources for this page

Verify at the official NPI Registry.