Individual provider Active NPI

Karen Marie Skutt, COTA/L

  • Occupational Therapy Assistant
  • Berea, OH
National Provider Identifier
1629515101
Registry record updated Jan 23, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Therapy AssistantTaxonomy code 224Z00000X
License
OTA01808 Issued in OH
Practice address
390 Fair St
Berea, OH 44017-2308
Phone
(216) 898-8300
NPI assigned
Jan 23, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 23, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy Assistant 224Z00000X OTA01808 OH Primary

Addresses

Primary practice location

390 Fair St
Berea, OH 44017-2308

Mailing address

1515 Columbia Rd
Westlake, OH 44145-2404
Phone (440) 915-3528

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

LicenseStateTypeSpecialty
OTA01808OHMDOccupational Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1485129600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1485129600000",
    "number": "1629515101",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1515 COLUMBIA RD",
            "city": "WESTLAKE",
            "state": "OH",
            "postal_code": "441452404",
            "telephone_number": "440-915-3528"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "390 FAIR ST",
            "city": "BEREA",
            "state": "OH",
            "postal_code": "440172308",
            "telephone_number": "216-898-8300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SKUTT",
        "first_name": "KAREN",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "COTA/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-01-23",
        "last_updated": "2017-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "OH",
            "license": "OTA01808",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Berea, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2017; 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.