Active NPI
Kimberly Ann Debos, COTA/L
- Occupational Therapist
- Ravenna, OH
National Provider Identifier
1164822235
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- OTA.05872
- Practice address
- 326 E Main St
Ravenna, OH 44266-3136 - Phone
- (330) 297-1436
- NPI assigned
- Aug 26, 2014
- Sex
- Female
- Sole proprietor
- Yes
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 | OTA.05872 | OH | Primary |
Addresses
Primary practice location
326 E Main St
Ravenna, OH 44266-3136
Mailing address
10688 Freedom St
Garrettsville, OH 44231-1138
Phone (330) 527-5881
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
| License | State | Type | Specialty |
|---|---|---|---|
| OTA.05872 | OH | MD | Occupational Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Portage County Esc | Past | Accepting new patients | |
| Portage County Educational Service Center | Past | Accepting new patients |
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.
-
- Local Education Agency (LEA)
- Ravenna, OH
- NPI 1619093481
-
- Local Education Agency (LEA)
- Ravenna, OH
- NPI 1336389964
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1409011200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1429833600000",
"number": "1164822235",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10688 FREEDOM ST",
"city": "GARRETTSVILLE",
"state": "OH",
"postal_code": "442311138",
"telephone_number": "330-527-5881"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "326 E MAIN ST",
"city": "RAVENNA",
"state": "OH",
"postal_code": "442663136",
"telephone_number": "330-297-1436"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DEBOS",
"first_name": "KIMBERLY",
"middle_name": "ANN",
"name_prefix": "Ms.",
"credential": "COTA/L",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2014-08-26",
"last_updated": "2015-04-24",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "OH",
"license": "OTA.05872",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Ravenna, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.