Individual provider Active NPI

Karen Marie Hubbard- Immerman

  • Occupational Therapy Assistant
  • Elmira, NY
National Provider Identifier
1275685752
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Therapy AssistantTaxonomy code 224Z00000X
License
0015811 Issued in NY
Practice address
555 E Market St
Elmira, NY 14901-3223
Phone
(607) 733-6541
Fax
(607) 737-1532
NPI assigned
Jan 17, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy Assistant 224Z00000X 0015811 NY Primary

Addresses

Primary practice location

555 E Market St
Elmira, NY 14901-3223

Mailing address

23 Halderman Hollow Rd
Elmira, NY 14903-9357
Phone (607) 562-3121

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
0015811NYMDOccupational Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1168992000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1275685752",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23 HALDERMAN HOLLOW RD",
            "city": "ELMIRA",
            "state": "NY",
            "postal_code": "149039357",
            "telephone_number": "607-562-3121"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "555 E MARKET ST",
            "city": "ELMIRA",
            "state": "NY",
            "postal_code": "149013223",
            "telephone_number": "607-733-6541",
            "fax_number": "607-737-1532"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUBBARD- IMMERMAN",
        "first_name": "KAREN",
        "middle_name": "MARIE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-17",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "NY",
            "license": "0015811",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Elmira, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.