Kimberly Anne Konnick, MS, OTR/L

Primary specialty

Pediatric Occupational TherapistTaxonomy code 225XP0200X

License

OC019113 Issued in PA

Practice address

1003 Wyoming Ave
Kingston, PA 18704-4002

Phone

(570) 846-0455

NPI assigned

May 12, 2023

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

Practice roles

Locations

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.

• Beyond Behavior Consulting

  • Behavior Analyst
  • Forty Fort, PA
  • NPI 1285390096
  NPD
• Beyond Behavior Consulting

  • Behavior Analyst
  • Forty Fort, PA
  • NPI 1043637747

  Pediatrics

  NPD (past)

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

{
    "created_epoch": "1683849600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1683849600000",
    "number": "1447940317",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1003 WYOMING AVE",
            "city": "KINGSTON",
            "state": "PA",
            "postal_code": "187044002",
            "telephone_number": "570-846-0455"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1003 WYOMING AVE",
            "city": "KINGSTON",
            "state": "PA",
            "postal_code": "187044002",
            "telephone_number": "570-846-0455"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KONNICK",
        "first_name": "KIMBERLY",
        "middle_name": "ANNE",
        "credential": "MS, OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-05-12",
        "last_updated": "2023-05-12",
        "certification_date": "2023-05-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "PA",
            "license": "OC019113",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kingston Spine & Sport Physical Therapy PC
• Mary Kathleen Kirchner
• Jacqueline Kishbaugh, BCBA
• Allison Kleinman, LSW
• Mikayla A Klym, DC
• Ann Marie Monica Kopec, LCSW
• Jonathan Robert Kopka, CRNA
• Judith N Koral, LPC MAC
• Michael E. Kordek, M.D.
• John Andrew Koschak, DPM

• Pediatric Occupational Therapist in Kingston, PA
• Providers in Kingston, PA by specialty
• Pediatric Occupational Therapist in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2023; 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.