Individual provider Active NPI

Kathrin Rebovich, COTA

  • Occupational Therapy Assistant
  • Fairlawn, OH
National Provider Identifier
1306328836
Registry record updated Aug 31, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Therapy AssistantTaxonomy code 224Z00000X
License
OTA007372 Issued in OH
Practice address
150 N Miller Rd Ste 150a
Fairlawn, OH 44333-3713
Phone
(330) 867-2240
Fax
(330) 630-3198
NPI assigned
Aug 31, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 31, 2018

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 OTA007372 OH Primary

Addresses

Primary practice location

150 N Miller Rd Ste 150a
Fairlawn, OH 44333-3713

Mailing address

150 N Miller Rd Ste 150a
Fairlawn, OH 44333-3713
Phone (330) 867-2240

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
OTA007372OHMDOccupational Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1535673600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1535673600000",
    "number": "1306328836",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "150 N MILLER RD STE 150A",
            "city": "FAIRLAWN",
            "state": "OH",
            "postal_code": "443333713",
            "telephone_number": "330-867-2240",
            "fax_number": "330-630-3198"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 N MILLER RD STE 150A",
            "city": "FAIRLAWN",
            "state": "OH",
            "postal_code": "443333713",
            "telephone_number": "330-867-2240",
            "fax_number": "330-630-3198"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REBOVICH",
        "first_name": "KATHRIN",
        "credential": "COTA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-08-31",
        "last_updated": "2018-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "OH",
            "license": "OTA007372",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairlawn, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2018; 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.