Kipp Ashley Roberts, COTA
Individual provider Active NPI Occupational Therapy Assistant · Oxford, FL
NPI 1154537611 · NPPES record last updated Aug 23, 2024
Key facts
- NPI
- 1154537611
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Occupational Therapy Assistant 224Z00000X
- License
- OTA12429 (FL)
- Practice address
- 4934 NE 123Rd LN
Oxford, FL 34484-9630 - Phone
- (352) 466-2143
- NPI assigned
- May 14, 2007
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| KY-A3608 | KY | MD | Occupational Therapy Assistant |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapy Assistant | 224Z00000X | OTA12429 | FL | Yes |
| Occupational Therapy Assistant | 224Z00000X | KY-A3608 | KY |
Addresses
Primary practice location
4934 NE 123Rd LN
Oxford, FL 34484-9630
Mailing address
4934 NE 123Rd LN
Oxford, FL 34484-9630
Phone (352) 466-2143
Other providers in Oxford, FL
- Gayle Reed
- Tracy Renna
- Randi Renee Restor
- Julie B. Riley
- Richard M Roach
- Joanne O'Keefe Rowe
- Brittany Rugg
- Nancy E Schrank
- Select Specialty Hospital - the Villages Inc
- Senior Home Companions, Inc
All providers in Oxford, FL · Occupational Therapy Assistant in Florida
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 23, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.