Active NPI
Kimberly M Sewall, OTR
- Occupational Therapist
- Buffalo, NY
National Provider Identifier
1487711974
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 013675-1
- Practice address
- 462 Grider St
Buffalo, NY 14215-3021 - Phone
- (716) 898-5040
- Fax
- (716) 898-3259
- NPI assigned
- Jan 3, 2007
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 013675-1 | NY | Primary |
Addresses
Primary practice location
462 Grider St
Buffalo, NY 14215-3021
Mailing address
736 W Delavan Ave
Buffalo, NY 14222-1221
Phone (716) 572-9509
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 |
|---|---|---|---|
| 013675-1 | NY | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1167782400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1487711974",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "736 W DELAVAN AVE",
"city": "BUFFALO",
"state": "NY",
"postal_code": "142221221",
"telephone_number": "716-572-9509"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "462 GRIDER ST",
"city": "BUFFALO",
"state": "NY",
"postal_code": "142153021",
"telephone_number": "716-898-5040",
"fax_number": "716-898-3259"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SEWALL",
"first_name": "KIMBERLY",
"middle_name": "M",
"name_prefix": "Miss",
"credential": "OTR",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-01-03",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "NY",
"license": "013675-1",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Buffalo, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.