Individual provider Active NPI

Kimberly Okicki

  • Personal Emergency Response Attendant
  • Lorain, OH
National Provider Identifier
1083075816
Registry record updated Nov 3, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Personal Emergency Response AttendantTaxonomy code 146D00000X
License
1131553 Issued in OH
Practice address
3700 Kolbe Rd
Lorain, OH 44053-1611
Phone
(440) 960-4526
NPI assigned
Mar 7, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 3, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Personal Emergency Response Attendant 146D00000X 1131553 OH Primary

Addresses

Primary practice location

3700 Kolbe Rd
Lorain, OH 44053-1611

Mailing address

3700 Kolbe Rd
Lorain, OH 44053-1611

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160322002363 OH Practitioner - Physician Assistant 3072810894 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
79.39 of 100Reported as group
Quality
69.41
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
1131553OHMDPersonal Emergency Response Attendant

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.

NPI Registry JSON

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

{
    "created_epoch": "1457308800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1541203200000",
    "number": "1083075816",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3700 KOLBE RD",
            "city": "LORAIN",
            "state": "OH",
            "postal_code": "440531611"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3700 KOLBE RD",
            "city": "LORAIN",
            "state": "OH",
            "postal_code": "440531611",
            "telephone_number": "440-960-4526"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OKICKI",
        "first_name": "KIMBERLY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-03-07",
        "last_updated": "2018-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "146D00000X",
            "taxonomy_group": "",
            "desc": "Personal Emergency Response Attendant",
            "state": "OH",
            "license": "1131553",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lorain, OH

Sources for this page

Verify at the official NPI Registry.