Active NPI
Jessica Kyne, COTA/L
- Occupational Therapy Assistant
- North Canton, OH
National Provider Identifier
1386068732
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapy Assistant
- License
- OTA05649
- Practice address
- 339 E Maple St
North Canton, OH 44720-2593 - Phone
- (330) 498-8200
- NPI assigned
- Feb 5, 2014
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapy Assistant | 224Z00000X | OTA05649 | OH | Primary |
Addresses
Primary practice location
339 E Maple St
North Canton, OH 44720-2593
Mailing address
205
PO Box 233
Spring Valley, OH 45370
Phone (937) 219-5561
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
| License | State | Type | Specialty |
|---|---|---|---|
| OTA05649 | OH | MD | Occupational Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1391558400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1391558400000",
"number": "1386068732",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "205",
"address_2": "PO BOX 233",
"city": "SPRING VALLEY",
"state": "OH",
"postal_code": "45370",
"telephone_number": "937-219-5561"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "339 E MAPLE ST",
"city": "NORTH CANTON",
"state": "OH",
"postal_code": "447202593",
"telephone_number": "330-498-8200"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KYNE",
"first_name": "JESSICA",
"credential": "COTA/L",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2014-02-05",
"last_updated": "2014-02-05",
"status": "A"
},
"taxonomies": [
{
"code": "224Z00000X",
"taxonomy_group": "",
"desc": "Occupational Therapy Assistant",
"state": "OH",
"license": "OTA05649",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in North Canton, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.