Jacob Darrald Klimoski, OTR/L

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

OTH-008393 Issued in AZ

Practice address

4475 E Knox Rd
Phoenix, AZ 85044-4848

Phone

(480) 893-1200

NPI assigned

Apr 15, 2021

Last updated

Apr 15, 2021By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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)

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.

• Desert Valley Pediatric Therapy

  • Specialist
  • Phoenix, AZ
  • NPI 1528209830
  NPD (past)

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

{
    "created_epoch": "1618444800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1618444800000",
    "number": "1669053211",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6426 S WILSON ST",
            "city": "TEMPE",
            "state": "AZ",
            "postal_code": "852833513",
            "telephone_number": "602-573-4943"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4475 E KNOX RD",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850444848",
            "telephone_number": "480-893-1200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KLIMOSKI",
        "first_name": "JACOB",
        "middle_name": "DARRALD",
        "credential": "OTR/L",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-04-15",
        "last_updated": "2021-04-15",
        "certification_date": "2021-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Occupational Therapist",
            "state": "AZ",
            "license": "OTH-008393",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jason M Klepfisz, O.D.
• Bruce A Kletscher, M.D.
• Stephanie J.B. Klever, R.N., B.S.N., M.ED.
• Oksana Klimenko, MD
• Lynn M Klimo, M.D.
• Elena Nickolaevna Klimova, NP
• Brian Paul Klinck, PSYD
• Heather L. Kline, RN.
• Kacey Kline, PTA
• Katelyn Kline

• Occupational Therapist in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Occupational Therapist in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2021; 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.