Individual provider Active NPI

Roxanne M Lincicome, COTA/L

  • Occupational Therapy Assistant
  • Louisville, KY
National Provider Identifier
1093209249
Registry record updated Jun 20, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Therapy AssistantTaxonomy code 224Z00000X
License
1358 Issued in OH
Practice address
2701 Chestnut Station CT
Louisville, KY 40299-6395
Phone
(800) 335-1060
NPI assigned
Jun 20, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 20, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy Assistant 224Z00000X 1358 OH Primary

Addresses

Primary practice location

2701 Chestnut Station CT
Louisville, KY 40299-6395

Mailing address

3075 Slack Rd
Mount Perry, OH 43760-9622
Phone (740) 221-6309

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
1358OHMDOrthopedic Chiropractor

NPI Registry JSON

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

{
    "created_epoch": "1529452800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1529452800000",
    "number": "1093209249",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3075 SLACK RD",
            "city": "MOUNT PERRY",
            "state": "OH",
            "postal_code": "437609622",
            "telephone_number": "740-221-6309"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2701 CHESTNUT STATION CT",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402996395",
            "telephone_number": "800-335-1060"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LINCICOME",
        "first_name": "ROXANNE",
        "middle_name": "M",
        "credential": "COTA/L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-06-20",
        "last_updated": "2018-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "OH",
            "license": "1358",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Louisville, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.