Active NPI
Hannah McKibben, OTR/L
- Occupational Therapist
- Bryan, OH
National Provider Identifier
1083213714
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- OT011026
- Practice address
- 442 W High St
Bryan, OH 43506-1681 - Phone
- (419) 636-4517
- Fax
- (419) 636-6438
- NPI assigned
- Oct 23, 2020
- 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 | OT011026 | OH | Primary |
Addresses
Primary practice location
442 W High St
Bryan, OH 43506-1681
Mailing address
11109 Parkview Plaza Dr # 117
Fort Wayne, IN 46845-1701
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | EPIC |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| OT011026 | OH | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1603411200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1603929600000",
"number": "1083213714",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11109 PARKVIEW PLAZA DR # 117",
"city": "FORT WAYNE",
"state": "IN",
"postal_code": "468451701"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "442 W HIGH ST",
"city": "BRYAN",
"state": "OH",
"postal_code": "435061681",
"telephone_number": "419-636-4517",
"fax_number": "419-636-6438"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCKIBBEN",
"first_name": "HANNAH",
"credential": "OTR/L",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-10-23",
"last_updated": "2020-10-29",
"certification_date": "2020-10-29",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "OH",
"license": "OT011026",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "CONNECT",
"endpointTypeDescription": "CONNECT URL",
"endpoint": "EPIC",
"affiliation": "N",
"address_1": "442 W High St",
"city": "Bryan",
"state": "OH",
"country_code": "US",
"postal_code": "435061681",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Bryan, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.