Kimberly Ann Fetchko, OT

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

OC007338L Issued in PA

Practice address

429 Manor Dr
Ebensburg, PA 15931-4917

Phone

(814) 471-2109

Fax

(814) 471-6902

NPI assigned

Nov 15, 2006

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

Other names 1

• Miss Kimberly Ann Braun Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1163548800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1487726360",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "117 HONEYSUCKLE LN",
            "city": "WINDBER",
            "state": "PA",
            "postal_code": "159639116",
            "telephone_number": "814-467-8103"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "429 MANOR DR",
            "city": "EBENSBURG",
            "state": "PA",
            "postal_code": "159314917",
            "telephone_number": "814-471-2109",
            "fax_number": "814-471-6902"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FETCHKO",
        "first_name": "KIMBERLY",
        "middle_name": "ANN",
        "name_prefix": "Mrs.",
        "credential": "OT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-15",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "PA",
            "license": "OC007338L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KIMBERLY",
            "last_name": "BRAUN",
            "middle_name": "ANN",
            "prefix": "MISS",
            "credential": "OT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Jacqueline Marie Evans, RN
• Family Behavioral Resources, Inc.
• Nichole E Feaster
• Bruce Allen Felix, O.D.
• Morgan Lynne Fenchak
• Samantha Janeen Fisher
• Sarah Flick, CNM WHNP
• Frank a Rezk
• Frank G Szczechowicz
• Haley Rochelle Frischkorn

• Occupational Therapist in Ebensburg, PA
• Providers in Ebensburg, PA by specialty
• Occupational Therapist in Pennsylvania

• 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.

Verify at the official NPI Registry.