Kimberly Lashae Vickery, COTA

Primary specialty

Occupational Therapy AssistantTaxonomy code 224Z00000X

License

2184 Issued in TN

Practice address

1645 Florence Rd
Savannah, TN 38372-5210

Phone

(731) 926-4200

Fax

(731) 926-4205

NPI assigned

May 14, 2013

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

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

{
    "created_epoch": "1368489600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1368489600000",
    "number": "1306282512",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "133 JORDAN LN",
            "city": "PARSONS",
            "state": "TN",
            "postal_code": "383635078",
            "telephone_number": "731-847-7240"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1645 FLORENCE RD",
            "city": "SAVANNAH",
            "state": "TN",
            "postal_code": "383725210",
            "telephone_number": "731-926-4200",
            "fax_number": "731-926-4205"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VICKERY",
        "first_name": "KIMBERLY",
        "middle_name": "LASHAE",
        "credential": "COTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-05-14",
        "last_updated": "2013-05-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "TN",
            "license": "2184",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Occupational Therapy Assistant in Savannah, TN
• Providers in Savannah, TN by specialty
• Occupational Therapy Assistant in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 2013; 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.