Individual provider Active NPI

Kimberly A Childers Deaton, OTR/L, CHT

  • Hand Occupational Therapist
  • Winchester, KY
National Provider Identifier
1720073836
Registry record updated Jan 31, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hand Occupational TherapistTaxonomy code 225XH1200X
License
R0823 Issued in KY
Practice address
160 Pedro Way
Winchester, KY 40391-8354
Phone
(859) 745-2152
Fax
(859) 745-2153
NPI assigned
Sep 14, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 31, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hand Occupational Therapist 225XH1200X R0823 KY Primary

Addresses

Primary practice location

160 Pedro Way
Winchester, KY 40391-8354

Mailing address

160 Pedro Way
Winchester, KY 40391-8354
Phone (859) 745-2152

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
R0823KYMDHand Occupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Kentucky Hand and Physical Therapy BC LLC Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1126656000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1327968000000",
    "number": "1720073836",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "160 PEDRO WAY",
            "city": "WINCHESTER",
            "state": "KY",
            "postal_code": "403918354",
            "telephone_number": "859-745-2152",
            "fax_number": "859-745-2153"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "160 PEDRO WAY",
            "city": "WINCHESTER",
            "state": "KY",
            "postal_code": "403918354",
            "telephone_number": "859-745-2152",
            "fax_number": "859-745-2153"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHILDERS DEATON",
        "first_name": "KIMBERLY",
        "middle_name": "A",
        "name_prefix": "Mrs.",
        "credential": "OTR/L, CHT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-09-14",
        "last_updated": "2012-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XH1200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Hand",
            "state": "KY",
            "license": "R0823",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Winchester, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2012; 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.