Individual provider Active NPI

Nicole Amy Kobman, OT

  • Occupational Therapist
  • Cincinnati, OH
National Provider Identifier
1386477438
Registry record updated Aug 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
OT004571 Issued in OH
Practice address
4916 N Bend Rd
Cincinnati, OH 45211-2360
Phone
(866) 360-9355
Fax
(866) 360-9355
NPI assigned
Aug 23, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 23, 2024

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 OT004571 OH Primary

Addresses

Primary practice location

4916 N Bend Rd
Cincinnati, OH 45211-2360

Mailing address

2401 Royal Manor PL
Fairfield, OH 45014-8600
Phone (513) 543-4377

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241003003840 OH Practitioner - Occupational Therapist in Private Practice 1658802467 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
University of Florida College of Medicine, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
My Wellness Team LLCGroup PAC ID 5890142145, 41 clinicians

Practice addresses (Care Compare)

4916 N Bend Rd
Cincinnati, OH 45211-2360
Phone (866) 360-9355

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
My Wellness Team LLC Occupational Therapist CurrentSince Sep 16, 2024 Accepting new patients

Locations

911 E 86th St
Ste 103
Indianapolis, IN 46240
Phone (812) 267-2841

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1724371200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724371200000",
    "number": "1386477438",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2401 ROYAL MANOR PL",
            "city": "FAIRFIELD",
            "state": "OH",
            "postal_code": "450148600",
            "telephone_number": "513-543-4377"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4916 N BEND RD",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452112360",
            "telephone_number": "866-360-9355",
            "fax_number": "866-360-9355"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOBMAN",
        "first_name": "NICOLE",
        "middle_name": "AMY",
        "credential": "OT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-08-23",
        "last_updated": "2024-08-23",
        "certification_date": "2024-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "OH",
            "license": "OT004571",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cincinnati, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.