Katie Kimble, COTA

Primary specialty

Occupational Therapy AssistantTaxonomy code 224Z00000X

License

004019-01 Issued in NY

Practice address

590 Fishers Station Dr Ste 130
Victor, NY 14564-9744

Phone

(585) 924-7207

NPI assigned

Jan 26, 2023

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

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 and National Provider Directory roles.

• Western New York Speech-Language Pathology, OT, and PT Consultants

  • Early Intervention Provider Agency
  • Victor, NY
  • NPI 1386812550
  NPD (past)

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

{
    "created_epoch": "1674691200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1674691200000",
    "number": "1235845868",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29 TWIN PONDS DR",
            "city": "SPENCERPORT",
            "state": "NY",
            "postal_code": "145591037",
            "telephone_number": "585-225-5099"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "590 FISHERS STATION DR STE 130",
            "city": "VICTOR",
            "state": "NY",
            "postal_code": "145649744",
            "telephone_number": "585-924-7207"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIMBLE",
        "first_name": "KATIE",
        "credential": "COTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-01-26",
        "last_updated": "2023-01-26",
        "certification_date": "2023-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "NY",
            "license": "004019-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Becca L Kershner
• Kevin Bolger DDS PLLC
• Melissa J Kieffer, MSED
• Jessica Kiesl
• Roy Hyunchul Kim, O.D.
• Kaitlyn Kinney, M.A.T.
• Clarise Klaver
• Beth S Knopf, B.S.
• Molly Koochekpour, DDS
• Shelly L Kordish

• Occupational Therapy Assistant in Victor, NY
• Providers in Victor, NY by specialty
• Occupational Therapy Assistant in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 2023; 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.