Kimberly Maxwell, OT

Primary specialty

Pediatric Occupational TherapistTaxonomy code 225XP0200X

License

0119001556 Issued in VA

Practice address

21000 Education CT
Broadlands, VA 20148-5526

Phone

(571) 252-1000

NPI assigned

Mar 21, 2007

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 identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Loudoun County Public Schools

  • Local Education Agency (LEA)
  • Broadlands, VA
  • NPI 1902151863
  NPD (past)

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

{
    "created_epoch": "1174435200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1522627200000",
    "number": "1598881922",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21000 EDUCATION CT",
            "city": "BROADLANDS",
            "state": "VA",
            "postal_code": "201485526",
            "telephone_number": "571-252-1000",
            "fax_number": "434-979-8536"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21000 EDUCATION CT",
            "city": "BROADLANDS",
            "state": "VA",
            "postal_code": "201485526",
            "telephone_number": "571-252-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAXWELL",
        "first_name": "KIMBERLY",
        "name_prefix": "Ms.",
        "credential": "OT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-21",
        "last_updated": "2018-04-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "VA",
            "license": "0119001556",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FIRST HEALTH",
            "identifier": "1906722",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SOUTHERN HEALTH",
            "identifier": "225539",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kelsie Lute
• Luxe Studio LLC
• Melissa Lynn Macdonald, O.D.
• Nicole Yeganeh Maham
• Anderea Nicole Mason, M.ED.
• Megan McAlister, M.A
• Courtney M McCarren, MS, CCC-SLP
• Jessica Kate McCarthy, MSW
• Kimberly McCartney
• Karen Elizabeth McKinley, PA-C

• Pediatric Occupational Therapist in Broadlands, VA
• Providers in Broadlands, VA by specialty
• Pediatric Occupational Therapist in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 2018; 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.