Active NPI
Gioconda Koludrovich, OT, CHT
- Occupational Therapist
- Akron, OH
National Provider Identifier
1235315409
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- OT 001655
- Practice address
- 3925 Embassy Pkwy
Akron, OH 44333-1782 - Phone
- (330) 668-4060
- NPI assigned
- Jan 17, 2008
- Sex
- Female
- Sole proprietor
- No
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 | OT 001655 | OH | Primary |
Addresses
Primary practice location
3925 Embassy Pkwy
Akron, OH 44333-1782
Mailing address
3925 Embassy Pkwy
Akron, OH 44333-1782
Phone (330) 668-4060
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| OT 001655 | OH | MD | Occupational Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Crystal Clinic Inc | Past | Accepting new patients | |
| Crystal Clinic, Inc. | 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.
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- NPI 1063966042
-
- Orthopaedic Surgery Physician
- Akron, OH
- NPI 1619906914
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1200528000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1200528000000",
"number": "1235315409",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3925 EMBASSY PKWY",
"city": "AKRON",
"state": "OH",
"postal_code": "443331782",
"telephone_number": "330-668-4060"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3925 EMBASSY PKWY",
"city": "AKRON",
"state": "OH",
"postal_code": "443331782",
"telephone_number": "330-668-4060"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KOLUDROVICH",
"first_name": "GIOCONDA",
"credential": "OT, CHT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-01-17",
"last_updated": "2008-01-17",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "OH",
"license": "OT 001655",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Akron, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.