Miranda Jane Knickerbocker, OTR/L

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

029377 Issued in NY

Practice address

882 Nys Rte 13
Cortland, NY 13045-3528

Phone

(607) 753-9375

Fax

(607) 758-9287

NPI assigned

Oct 2, 2024

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1727827200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727827200000",
    "number": "1609694108",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "882 NYS RTE 13",
            "city": "CORTLAND",
            "state": "NY",
            "postal_code": "130453528",
            "telephone_number": "607-753-9375",
            "fax_number": "607-758-9287"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "882 NYS RTE 13",
            "city": "CORTLAND",
            "state": "NY",
            "postal_code": "130453528",
            "telephone_number": "607-753-9375",
            "fax_number": "607-758-9287"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KNICKERBOCKER",
        "first_name": "MIRANDA",
        "middle_name": "JANE",
        "name_prefix": "Miss",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-10-02",
        "last_updated": "2024-10-02",
        "certification_date": "2024-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NY",
            "license": "029377",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Deidre Kirkem
• John Edward Kirker, RPH
• Dana McKenney Kitts, OTR/L
• Lorena J Klaes, RPH
• Aaron Klein
• Nicole Cecile Koekebacker, MAT, MS
• Wendy M Kolodziejczyk, P.T.
• Lisa Ann Kolts, LPN
• Lauren Elizabeth Kostuk, CCC-SLP
• Rachel Erin Kosty, PT, DPT

• Occupational Therapist in Cortland, NY
• Providers in Cortland, NY by specialty
• Occupational Therapist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2024; 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.