Active NPI
Kimberly Yvonne Chiappetta, OTR CTR
- Occupational Therapist
- Indianapolis, IN
National Provider Identifier
1477659936
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 31002977A
- 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, 2009
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 200234290 | Medicaid | IN | |
| 000000179534 | Other | ANTHEM HEALTH PLAN |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TX
Enrollment records 1
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
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
| License | State | Type | Specialty |
|---|---|---|---|
| 113998 | TX | MD | Licensed Vocational Nurse |
| 31002977A | IN | MD | Occupational Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Colleyville Physical Therapy and Sports Rehab, PC | Occupational Therapist | Current | 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.
-
- Physical Therapist
- Colleyville, TX
- NPI 1134158371
Occupational Therapist
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.