Kelley Anne Hieronymus, COTA/L

Primary specialty

Occupational Therapy AssistantTaxonomy code 224Z00000X

License

OC 00000444 Issued in WA

Practice address

817 E Plum St
Moses Lake, WA 98837-1870

Phone

(509) 765-7835

NPI assigned

Nov 21, 2012

Sex

Female

Sole proprietor

Yes

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

State licenses

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

{
    "created_epoch": "1353456000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1353456000000",
    "number": "1487998902",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2013 LEANNE AVE",
            "city": "MOSES LAKE",
            "state": "WA",
            "postal_code": "988372599",
            "telephone_number": "509-765-3041"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "817 E PLUM ST",
            "city": "MOSES LAKE",
            "state": "WA",
            "postal_code": "988371870",
            "telephone_number": "509-765-7835"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HIERONYMUS",
        "first_name": "KELLEY",
        "middle_name": "ANNE",
        "credential": "COTA/L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-11-21",
        "last_updated": "2012-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "WA",
            "license": "OC 00000444",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Richard Tyler Hesselgesser, DMD
• Izzabella Hiatt-Jackson
• Kyle Thomas Hickman, ARNP
• Patrick J. Hickman, D.C.
• Meghan Hicks, MD
• William Thomas Hilliard, DDS
• Abigail Hines, LMT
• Eugena Louise Hintz
• Kevin Neil Hodgson, DPT
• Jennifer Hoffman, RN

• Occupational Therapy Assistant in Moses Lake, WA
• Providers in Moses Lake, WA by specialty
• Occupational Therapy Assistant in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2012; 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.