Individual provider Active NPI

Kimberly Yvonne Chiappetta, OTR CTR

  • Occupational Therapist
  • Indianapolis, IN
National Provider Identifier
1477659936
Registry record updated May 11, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
31002977A Issued in IN
Practice address
8501 Harcourt Rd
Indianapolis, IN 46260-2046
Phone
(317) 875-9105
Fax
(317) 875-8638
NPI assigned
Sep 15, 2006
Last updated
May 11, 2009By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 11, 2009

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 31002977A IN Primary
Hand Occupational Therapist 225XH1200X 31002977A IN

Addresses

Primary practice location

8501 Harcourt Rd
Indianapolis, IN 46260-2046

Mailing address

8501 Harcourt Rd
Indianapolis, IN 46260-2046
Phone (317) 875-9105

Other identifiers 2

IdentifierTypeStateIssuer
200234290MedicaidIN
000000179534OtherANTHEM HEALTH PLAN

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140729001926 TX Practitioner - Occupational Therapist in Private Practice 4183772197 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Colleyville Physical Therapy and Sports Rehab, PCGroup PAC ID 1153315791, 12 clinicians

Practice addresses (Care Compare)

1109 Church St
Colleyville, TX 76034-5849
Phone (817) 498-3919

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Tumor Registrar

State licenses

LicenseStateTypeSpecialty
113998TXMDLicensed Vocational Nurse
31002977AINMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Colleyville Physical Therapy and Sports Rehab, PC Occupational Therapist CurrentSince May 8, 2014 Accepting new patients

Locations

1109 Church St
Colleyville, TX 76034
Phone (817) 498-3919

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1158278400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1242000000000",
    "number": "1477659936",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8501 HARCOURT RD",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462602046",
            "telephone_number": "317-875-9105",
            "fax_number": "317-875-8638"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8501 HARCOURT RD",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462602046",
            "telephone_number": "317-875-9105",
            "fax_number": "317-875-8638"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHIAPPETTA",
        "first_name": "KIMBERLY",
        "middle_name": "YVONNE",
        "credential": "OTR CTR",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-15",
        "last_updated": "2009-05-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "IN",
            "license": "31002977A",
            "primary": true
        },
        {
            "code": "225XH1200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Hand",
            "state": "IN",
            "license": "31002977A",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200234290",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM HEALTH PLAN",
            "identifier": "000000179534",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 2009; 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.