Individual provider Active NPI

Keri Ann Overly-Wear, O.T.

  • Occupational Therapist
  • Kinsman, OH
National Provider Identifier
1659584845
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
006795 Issued in OH
Practice address
7966 Jewell Greenville Rd
Kinsman, OH 44428-9591
Phone
(330) 876-0572
Fax
(440) 293-8432
NPI assigned
May 7, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 006795 OH Primary

Addresses

Primary practice location

7966 Jewell Greenville Rd
Kinsman, OH 44428-9591

Mailing address

7966 Jewell Greenville Rd
Kinsman, OH 44428-9591
Phone (330) 876-0572

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20221118001009 OH Practitioner - Occupational Therapist in Private Practice 0749658912 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
006795OHMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Antonine Therapy Center CurrentSince Oct 20, 2022 Accepting new patients
Youngstown Hearing and Speech Center Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1178496000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1659584845",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7966 JEWELL GREENVILLE RD",
            "city": "KINSMAN",
            "state": "OH",
            "postal_code": "444289591",
            "telephone_number": "330-876-0572",
            "fax_number": "440-293-8432"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7966 JEWELL GREENVILLE RD",
            "city": "KINSMAN",
            "state": "OH",
            "postal_code": "444289591",
            "telephone_number": "330-876-0572",
            "fax_number": "440-293-8432"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OVERLY-WEAR",
        "first_name": "KERI",
        "middle_name": "ANN",
        "name_prefix": "Mrs.",
        "credential": "O.T.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-07",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "OH",
            "license": "006795",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kinsman, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.