Kimberly Rey Roach, LMT, L/OTR

Primary specialty

Pediatric Occupational TherapistTaxonomy code 225XP0200X

License

17463 Issued in FL

Practice address

250 NW 76TH Dr
Gainesville, FL 32607-6668

Phone

(352) 505-6363

NPI assigned

Oct 11, 2012

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

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": "1349913600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1451952000000",
    "number": "1376895540",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10502 NW 47TH TER",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326537835",
            "telephone_number": "352-222-3409"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "250 NW 76TH DR",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326076668",
            "telephone_number": "352-505-6363"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROACH",
        "first_name": "KIMBERLY",
        "middle_name": "REY",
        "credential": "LMT, L/OTR",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-10-11",
        "last_updated": "2016-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "FL",
            "license": "MA67664",
            "primary": false
        },
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "FL",
            "license": "17463",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Chantel Lesle Rizzardi, CNA
• Emily Rizzitello
• Hannah Marie Rizzo, OTD, OTR/L
• Theresa Marie Rizzo, A.P.
• Alexandra Theresa Issa Roach, M.D.
• Katie Roark, M.A., CCC-SLP
• Steven Forest Roark, MD
• Robbins Investments Inc.
• David Merritt Robbins
• Gregory L Robbins

• Pediatric Occupational Therapist in Gainesville, FL
• Providers in Gainesville, FL by specialty
• Pediatric Occupational Therapist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2016; 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.