Kimberly Berthold Jerrom, OTR/L

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

11521 Issued in NC

Practice address

5125 Michaux Rd
Greensboro, NC 27410-9836

Phone

(828) 774-5222

NPI assigned

Aug 11, 2015

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NC

Enrollment records 1

Specialty

Occupational Therapist in Private Practice

Education

Other, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Broad River Rehabilitation

  • Occupational Therapist
  • Charlotte, NC
  • NPI 1902317589
  Medicare reassignment NPD

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

{
    "created_epoch": "1439251200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1671580800000",
    "number": "1639545825",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3805 BAYLOR ST",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274053101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5125 MICHAUX RD",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274109836",
            "telephone_number": "828-774-5222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JERROM",
        "first_name": "KIMBERLY",
        "middle_name": "BERTHOLD",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-08-11",
        "last_updated": "2022-12-21",
        "certification_date": "2022-12-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "FL",
            "license": "OT16933",
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NC",
            "license": "11521",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCBOT",
            "identifier": "11521",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Scott McKenzie Jensen, DMD
• Cory Jentz, DC
• Jeremy Phillips
• Margaret A Jerger, PHD,MA,CCC-SLP
• Jerome O Spruill MD PA
• Jill Evelyn Jertson, M.D.
• Ryan Christopher Jessee, MD
• Belvin J Jessup II, CH
• Thelma Jeter, BSN, RN
• Douglas Jewson, D.D.S.

• Occupational Therapist in Greensboro, NC
• Providers in Greensboro, NC by specialty
• Occupational Therapist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.