Kimberly A. Desau, MS, OTR/L

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

OC005793L Issued in PA

Practice address

516 Saint Marys Villa Rd
Elmhurst Township, PA 18444

Phone

(570) 842-7621

Fax

(570) 842-3813

NPI assigned

Nov 17, 2011

Last updated

Aug 28, 2018By the provider in NPPES

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)

Not enrolled

Credentials

Master of Science

State licenses

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

{
    "created_epoch": "1321488000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1535414400000",
    "number": "1225305311",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "516 SAINT MARYS VILLA RD",
            "city": "ELMHURST TOWNSHIP",
            "state": "PA",
            "postal_code": "184449683",
            "telephone_number": "570-842-7621",
            "fax_number": "570-842-3813"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "516 SAINT MARYS VILLA RD",
            "city": "ELMHURST TOWNSHIP",
            "state": "PA",
            "postal_code": "18444",
            "telephone_number": "570-842-7621",
            "fax_number": "570-842-3813"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "106 Glennwood Dr",
            "address_purpose": "LOCATION",
            "city": "Hawley",
            "state": "PA",
            "postal_code": "184289668",
            "country_code": "US",
            "telephone_number": "570-352-8777",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DESAU",
        "first_name": "KIMBERLY",
        "middle_name": "A.",
        "name_prefix": "Ms.",
        "credential": "MS, OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-11-17",
        "last_updated": "2018-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "PA",
            "license": "OC005793L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jeffrey Daniel Kramer
• St. Mary's Villa Nursing Home, Inc.

• Occupational Therapist in Elmhurst Township, PA
• Providers in Elmhurst Township, PA by specialty
• Occupational Therapist in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2018; 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.