Individual provider Active NPI

Keri Evans, OTR/L

  • Physical Rehabilitation Occupational Therapist
  • Chagrin Falls, OH
National Provider Identifier
1548615537
Registry record updated Apr 27, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Rehabilitation Occupational TherapistTaxonomy code 225XP0019X
License
007548 Issued in OH
Practice address
16695 Chillicothe Rd
Chagrin Falls, OH 44023-4578
Phone
(440) 543-4221
NPI assigned
Apr 27, 2016
Last updated
Apr 27, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 27, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Rehabilitation Occupational Therapist 225XP0019X 007548 OH Primary

Addresses

Primary practice location

16695 Chillicothe Rd
Chagrin Falls, OH 44023-4578

Mailing address

16695 Chillicothe Rd
Chagrin Falls, OH 44023-4578
Phone (440) 543-4221

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200804002500 OH Practitioner - Occupational Therapist in Private Practice 6800211137 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Buckeye Senior Rehab LLCGroup PAC ID 4284017542, 16 clinicians

Practice addresses (Care Compare)

7750 Paragon Rd
Washington Township, OH 45459-4050
Phone (937) 800-1030

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
007548OHMDPhysical Rehabilitation Occupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Legacy Healthcare Services Inc CurrentSince Jul 2, 2020 Accepting new patients
Legacy Healthcare Services Inc CurrentSince Jul 2, 2020 Accepting new patients
Buckeye Senior Rehab LLC CurrentSince Jun 1, 2024 Accepting new patients
Buckeye Senior Rehab LLC CurrentSince Jun 1, 2024 Accepting new patients

Locations

110 Horizon Dr
#310
Raleigh, NC 27615

7750 Paragon Rd
Washington Township, OH 45459
Phone (937) 291-3780

Organizations & group practices 4

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": "1461715200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1461715200000",
    "number": "1548615537",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16695 CHILLICOTHE RD",
            "city": "CHAGRIN FALLS",
            "state": "OH",
            "postal_code": "440234578",
            "telephone_number": "440-543-4221"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16695 CHILLICOTHE RD",
            "city": "CHAGRIN FALLS",
            "state": "OH",
            "postal_code": "440234578",
            "telephone_number": "440-543-4221"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EVANS",
        "first_name": "KERI",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-04-27",
        "last_updated": "2016-04-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XP0019X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Physical Rehabilitation",
            "state": "OH",
            "license": "007548",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chagrin Falls, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 2016; 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.