Individual provider Active NPI

Kim Schmucker, OTR/L

  • Occupational Therapist
  • Lebanon, OH
National Provider Identifier
1336684067
Registry record updated Jan 4, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
OT3466 Issued in OH
Practice address
1879 Deerfield Rd
Lebanon, OH 45036-8602
Phone
(513) 695-2961
NPI assigned
Jan 4, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 4, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X OT3466 OH Primary

Addresses

Primary practice location

1879 Deerfield Rd
Lebanon, OH 45036-8602

Mailing address

1422 Shawnee Run Dr
Maineville, OH 45039-7234
Phone (419) 583-0439

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
OT3466OHMDOccupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1483488000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1483488000000",
    "number": "1336684067",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1422 SHAWNEE RUN DR",
            "city": "MAINEVILLE",
            "state": "OH",
            "postal_code": "450397234",
            "telephone_number": "419-583-0439"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1879 DEERFIELD RD",
            "city": "LEBANON",
            "state": "OH",
            "postal_code": "450368602",
            "telephone_number": "513-695-2961"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHMUCKER",
        "first_name": "KIM",
        "credential": "OTR/L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-01-04",
        "last_updated": "2017-01-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "OH",
            "license": "OT3466",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lebanon, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2017; 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.