Active NPI
Kimberly A Jolly, COTA
- Occupational Therapy Assistant
- Omaha, NE
National Provider Identifier
1699058065
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapy Assistant
- License
- 872
- Practice address
- 3110 Scott Cir
Omaha, NE 68112-2604 - Phone
- (402) 203-6112
- Fax
- (402) 932-1888
- NPI assigned
- Sep 22, 2011
- Last updated
- Sep 22, 2011
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapy Assistant | 224Z00000X | 872 | NE | Primary |
Addresses
Primary practice location
3110 Scott Cir
Omaha, NE 68112-2604
Mailing address
3515 N 93Rd Ave Apt 6
Omaha, NE 68134-4672
Phone (402) 890-7883
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
| License | State | Type | Specialty |
|---|---|---|---|
| 872 | NE | MD | Hearing Instrument Specialist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1316649600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1316649600000",
"number": "1699058065",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3515 N 93RD AVE APT 6",
"city": "OMAHA",
"state": "NE",
"postal_code": "681344672",
"telephone_number": "402-890-7883",
"fax_number": "402-932-1888"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3110 SCOTT CIR",
"city": "OMAHA",
"state": "NE",
"postal_code": "681122604",
"telephone_number": "402-203-6112",
"fax_number": "402-932-1888"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JOLLY",
"first_name": "KIMBERLY",
"middle_name": "A",
"credential": "COTA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-09-22",
"last_updated": "2011-09-22",
"status": "A"
},
"taxonomies": [
{
"code": "224Z00000X",
"taxonomy_group": "",
"desc": "Occupational Therapy Assistant",
"state": "NE",
"license": "872",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Omaha, NE
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.