Kristen Tebbutt, MS OTR/L

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

5201009332 Issued in MI

Practice address

9444 Lapeer Rd Unit 6
Davison, MI 48423-1755

Phone

(914) 294-4050

NPI assigned

Aug 14, 2007

Last updated

Jan 9, 2024By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other names 1

• Kristen Michele Petronio Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Frederick Health Hospital Inc

  dba Frederick Health Hospital

  • General Acute Care Hospital
  • Frederick, MD
  • NPI 1538165527
  NPD (past)

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

{
    "created_epoch": "1187049600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704758400000",
    "number": "1184816027",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4904 CARLSON PARK DR",
            "city": "TROY",
            "state": "MI",
            "postal_code": "480987102",
            "telephone_number": "248-506-2520"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9444 LAPEER RD UNIT 6",
            "city": "DAVISON",
            "state": "MI",
            "postal_code": "484231755",
            "telephone_number": "914-294-4050"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1540 Fording Island Rd Ste 20",
            "address_purpose": "LOCATION",
            "city": "Hilton Head Island",
            "state": "SC",
            "postal_code": "299261145",
            "country_code": "US",
            "telephone_number": "800-836-6000 x408",
            "fax_number": "800-829-4916",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TEBBUTT",
        "first_name": "KRISTEN",
        "credential": "MS OTR/L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-08-14",
        "last_updated": "2024-01-09",
        "certification_date": "2024-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "IL",
            "license": "56008106",
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "MI",
            "license": "5201009332",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KRISTEN",
            "last_name": "PETRONIO",
            "middle_name": "MICHELE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Shelly Swayze
• James E Szumowicz
• Clint A Tan, PT
• April Marie Tatarsky
• Gregory Taylor
• Bethany Michaela-Clark Tecson, MOT, OTR/L
• Nicole Marie Tefft, LMT
• Brooke Terwilliger, DC
• The Way of the Lotus Counseling and Wellness, LLC
• Deana Thompson, NP

• Occupational Therapist in Davison, MI
• Providers in Davison, MI by specialty
• Occupational Therapist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2024; 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.