Active NPI
Kelly Huebert, OTR/L
- Occupational Therapist
- Ravenna, OH
National Provider Identifier
1720831449
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- OT011310
- Practice address
- 6831 N Chestnut St
Ravenna, OH 44266-3929 - Phone
- (330) 297-4564
- NPI assigned
- Apr 10, 2024
- 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 Therapist | 225X00000X | OT011310 | OH | Primary |
Addresses
Primary practice location
6831 N Chestnut St
Ravenna, OH 44266-3929
Mailing address
68 Cranwood LN
Orchard Park, NY 14127-3286
Phone (716) 440-7747
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 |
|---|---|---|---|
| OT011310 | OH | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1712707200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1712707200000",
"number": "1720831449",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "68 CRANWOOD LN",
"city": "ORCHARD PARK",
"state": "NY",
"postal_code": "141273286",
"telephone_number": "716-440-7747"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6831 N CHESTNUT ST",
"city": "RAVENNA",
"state": "OH",
"postal_code": "442663929",
"telephone_number": "330-297-4564"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HUEBERT",
"first_name": "KELLY",
"credential": "OTR/L",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-04-10",
"last_updated": "2024-04-10",
"certification_date": "2024-04-10",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "OH",
"license": "OT011310",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Ravenna, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.