Individual provider Active NPI

Kimberley Berry

  • Occupational Therapist
  • Winter Haven, FL
National Provider Identifier
1215495155
Registry record updated Jan 5, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
13078 Issued in MA
Practice address
7702 Waterview Way
Winter Haven, FL 33884-3553
Phone
(321) 732-0368
NPI assigned
Mar 11, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 5, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 13078 MA Primary

Addresses

Primary practice location

7702 Waterview Way
Winter Haven, FL 33884-3553

Mailing address

109 E Belmar St
Lakeland, FL 33803-2205

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240205004439 FL Practitioner - Occupational Therapist in Private Practice 7214370485 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
13078MAMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Legacy Healthcare Services, Inc Occupational Therapist CurrentSince Apr 14, 2024 Accepting new patients
Legacy Healthcare Services Inc Occupational Therapist CurrentSince Apr 14, 2024 Accepting new patients
Homeside Rehab Florida LLC Occupational Therapist CurrentSince Jan 1, 2024 Accepting new patients
Love & Behavior Therapy LLC CurrentSince Jun 12, 2022 Accepting new patients
Love and Co Therapeutic Interventions,LLC PastSince Jan 17, 2022 Accepting new patients

Locations

7000 W Palmetto Park Rd
Ste 210
Boca Raton, FL 33433
Phone (561) 409-4490

2219 Chiquita Blvd S
Cape Coral, FL 33991
Phone (239) 205-3654

8213 Killearn Lakes Ter
Tallahassee, FL 32312
Phone (850) 391-0979

38130 Pretty Pond Rd
Zephyrhills, FL 33540
Phone (813) 400-2291

110 Horizon Dr
Ste 310
Raleigh, NC 27615
Phone (970) 215-3300

3846 Flatlands Ave
Brooklyn, NY 11234
Phone (347) 875-0806

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1552262400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641340800000",
    "number": "1215495155",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "109 E BELMAR ST",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338032205"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7702 WATERVIEW WAY",
            "city": "WINTER HAVEN",
            "state": "FL",
            "postal_code": "338843553",
            "telephone_number": "321-732-0368"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERRY",
        "first_name": "KIMBERLEY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-03-11",
        "last_updated": "2022-01-05",
        "certification_date": "2022-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "MA",
            "license": "13078",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Winter Haven, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.