Bamlaku Kebede, OTA

Primary specialty

Occupational Therapy AssistantTaxonomy code 224Z00000X

License

470224 Issued in KS

Practice address

3811 W 52ND St
Roeland Park, KS 66205-1458

Phone

(913) 579-8556

NPI assigned

Mar 22, 2022

Last updated

Mar 22, 2022By the provider in NPPES

Sex

Male

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 1

Electronic endpoints 1

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• St. Nicholas Children's Therapies LLC

  • Occupational Therapist
  • Roeland Park, KS
  • NPI 1285626937
  NPD

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

{
    "created_epoch": "1647907200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1647907200000",
    "number": "1619626900",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "977 E NEW LONDON DR",
            "city": "OLATHE",
            "state": "KS",
            "postal_code": "660617117",
            "telephone_number": "913-232-3577"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3811 W 52ND ST",
            "city": "ROELAND PARK",
            "state": "KS",
            "postal_code": "662051458",
            "telephone_number": "913-579-8556"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KEBEDE",
        "first_name": "BAMLAKU",
        "credential": "OTA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-03-22",
        "last_updated": "2022-03-22",
        "certification_date": "2022-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "KS",
            "license": "470224",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "YBC15K024376",
            "state": "KS"
        }
    ],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "Olathe",
            "affiliation": "N",
            "address_1": "3811 W 52nd St",
            "city": "Roeland Park",
            "state": "KS",
            "country_code": "US",
            "postal_code": "662051458",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Kelsey Marie Ingold, LMSW
• Intensive Family Counseling, Inc.
• Paul Aram Jernigan, O.D.
• Kansas Pain Management
• Jeffrey M Kaplan, M.D.
• Samuel Keller
• Jennifer L Kennedy, LSCSW
• Ashley Christine Knedlik, LMSW
• Sophia Claire Kramer
• Melanie Beth Kreifels, MA, LPC

• Occupational Therapy Assistant in Roeland Park, KS
• Providers in Roeland Park, KS by specialty
• Occupational Therapy Assistant in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 2022; 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.