Cassidy Leigh Icenhour

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

OT012243 Issued in OH

Practice address

400 N Erie Hwy Ste a
Hamilton, OH 45011-4264

Phone

(513) 887-3710

NPI assigned

Nov 2, 2022

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1667347200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1667347200000",
    "number": "1285341941",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "248 TRIPLE CROWN DR",
            "city": "LEBANON",
            "state": "OH",
            "postal_code": "450368023",
            "telephone_number": "501-744-9594"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 N ERIE HWY STE A",
            "city": "HAMILTON",
            "state": "OH",
            "postal_code": "450114264",
            "telephone_number": "513-887-3710"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ICENHOUR",
        "first_name": "CASSIDY",
        "middle_name": "LEIGH",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-11-02",
        "last_updated": "2022-11-02",
        "certification_date": "2022-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Occupational Therapist",
            "state": "OH",
            "license": "OT012243",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "OT012243",
            "state": "OH"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "bcesc.org",
            "affiliation": "N",
            "address_1": "400 N Erie Hwy Ste A",
            "city": "Hamilton",
            "state": "OH",
            "country_code": "US",
            "postal_code": "450114264",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Occupational Therapist in Hamilton, OH
• Providers in Hamilton, OH by specialty
• Occupational Therapist in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2022; 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.