Mercy Taby Jimkelly, M.A

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

013587-1 Issued in NY

Practice address

13949 85TH Drive
Briarwood, NY 11435

Phone

(718) 739-0623

NPI assigned

Dec 22, 2008

Last updated

Dec 22, 2008By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Mercy Taby Suveeharan Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Arts

State licenses

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

{
    "created_epoch": "1229904000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1229904000000",
    "number": "1437395480",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13949 85TH DRIVE",
            "city": "BRIARWOOD",
            "state": "NY",
            "postal_code": "11435",
            "telephone_number": "718-739-0623"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13949 85TH DRIVE",
            "city": "BRIARWOOD",
            "state": "NY",
            "postal_code": "11435",
            "telephone_number": "718-739-0623"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JIMKELLY",
        "first_name": "MERCY",
        "middle_name": "TABY",
        "name_prefix": "Ms.",
        "credential": "M.A",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-12-22",
        "last_updated": "2008-12-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NY",
            "license": "013587-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MERCY",
            "last_name": "SUVEEHARAN",
            "middle_name": "TABY",
            "credential": "M.A",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Occupational Therapist in Briarwood, NY
• Providers in Briarwood, NY by specialty
• Occupational Therapist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 22, 2008; 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.