Active NPI
Kelly Sue Cicon, P.T.
- Physical Therapist
- Jefferson, OH
National Provider Identifier
1427238518
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT 005440
- Practice address
- 404 Brittany LN
Jefferson, OH 44047-1352 - Phone
- (440) 576-8772
- NPI assigned
- Nov 6, 2007
- Last updated
- Nov 6, 2007
- 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 |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PT 005440 | OH | Primary |
Addresses
Primary practice location
404 Brittany LN
Jefferson, OH 44047-1352
Mailing address
404 Brittany LN
Jefferson, OH 44047-1352
Phone (440) 576-8772
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 |
|---|---|---|---|
| PT 005440 | OH | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1194307200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1194307200000",
"number": "1427238518",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "404 BRITTANY LN",
"city": "JEFFERSON",
"state": "OH",
"postal_code": "440471352",
"telephone_number": "440-576-8772"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "404 BRITTANY LN",
"city": "JEFFERSON",
"state": "OH",
"postal_code": "440471352",
"telephone_number": "440-576-8772"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CICON",
"first_name": "KELLY",
"middle_name": "SUE",
"name_prefix": "Mrs.",
"credential": "P.T.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-11-06",
"last_updated": "2007-11-06",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "OH",
"license": "PT 005440",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Jefferson, OH
- Sharon K Cattell, LPN
- Christine Marie Cercek, INDPENDENT PROVIDER
- Tiffany Marie Chambers, LPN
- Jordan Ann Chittle, DPT
- Wenonah Chonich, RN
- Laxman Reddy Cingireddi, M.D.,
- Community Dialysis Center (Center for Dialysis Care, Jefferson)
- Jamie Christina Costella
- County of Ashtabula (Ashtabula County Health Department)
- Kathleen Susan Crim, OCCUPATIONAL THERAPI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.