Cheryl Anne Ubelhor Kotyuk

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

34004171A Issued in IN

Practice address

100 Long Branch Way
Saint Augustine, FL 32086-4864

Phone

(765) 491-8142

NPI assigned

Jun 14, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1623628800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623628800000",
    "number": "1093383200",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 LONG BRANCH WAY",
            "city": "SAINT AUGUSTINE",
            "state": "FL",
            "postal_code": "320864864",
            "telephone_number": "765-491-8142"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 LONG BRANCH WAY",
            "city": "SAINT AUGUSTINE",
            "state": "FL",
            "postal_code": "320864864",
            "telephone_number": "765-491-8142"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "UBELHOR KOTYUK",
        "first_name": "CHERYL",
        "middle_name": "ANNE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-06-14",
        "last_updated": "2021-06-14",
        "certification_date": "2021-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IN",
            "license": "34004171A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rebecca Rose Bulen Tuttle, OTR/L, PT
• Tyler Darl Albrecht D.C., P.a.
• Emily Weldon Tyler, D.M.D.
• Kelli M. Tyson, ARNP
• U Enterprises, LLC
• Ononike Umerah
• Under the Barbell Physical Therapy & Performance LLC
• Urgent Care Cure, LLC
• Maria Urrea
• Naveen Chandra Raj Urs, MBBS, DM (RADIOLOGY)

• Clinical Social Worker in Saint Augustine, FL
• Providers in Saint Augustine, FL by specialty
• Clinical Social Worker in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 2021; 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.