Active NPI
Penne Clos
- Occupational Therapist
- Southgate, KY
National Provider Identifier
1548713019
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 133698
- Practice address
- 251 Linden Ave
Southgate, KY 41071-3213 - Phone
- (859) 757-7765
- NPI assigned
- Aug 1, 2016
- Last updated
- Aug 1, 2016
- Sex
- Female
- Sole proprietor
- Yes
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 | 133698 | KY | Primary |
Addresses
Primary practice location
251 Linden Ave
Southgate, KY 41071-3213
Mailing address
251 Linden Ave
Southgate, KY 41071-3213
Phone (859) 757-7765
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 |
|---|---|---|---|
| 133698 | KY | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1470009600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1470009600000",
"number": "1548713019",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "251 LINDEN AVE",
"city": "SOUTHGATE",
"state": "KY",
"postal_code": "410713213",
"telephone_number": "859-757-7765"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "251 LINDEN AVE",
"city": "SOUTHGATE",
"state": "KY",
"postal_code": "410713213",
"telephone_number": "859-757-7765"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CLOS",
"first_name": "PENNE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2016-08-01",
"last_updated": "2016-08-01",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "KY",
"license": "133698",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Southgate, KY
- Theresa M Bedinghaus
- Joan O Bovard, APRN FNP-BC
- Allyson Bridewell, PA-C
- Danilo Joson Calderon, M.D.
- Cincinnati Health Care Group PSC
- Alexandra Rene Daniels, MA, BCBA, LBA, COBA
- DRS Cullen & Kreilein, PSC, Inc.
- Ronald Lee Durrett, CPO
- Dva Renal Healthcare Inc (South Hill Dialysis)
- Erin Elfers, M.ED, BCBA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.