Active NPI
Kimberly S Mollo, OTD, OTR/L
- Specialist
- Lafayette Hill, PA
National Provider Identifier
1730362450
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- License
- OC010410
- Practice address
- 600 Germantown Pike Ste a
Lafayette Hill, PA 19444 - Phone
- (215) 290-0817
- NPI assigned
- Dec 17, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | U1-0001454 | DE | |
| Specialist | 174400000X | 46TR00443400 | NJ | |
| Mental Health Occupational Therapist | 225XM0800X | |||
| Specialist | 174400000X | OC010410 | PA | Primary |
Addresses
Primary practice location
600 Germantown Pike Ste a
Lafayette Hill, PA 19444
Mailing address
600 Germantown Pike Ste a
Lafayette Hill, PA 19444-1800
Phone (215) 290-0817
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 022381 | Other | NY | NEW YORK LICENSE |
| 46TR00443400 | Other | NJ | OCCUPATIONAL THERAPY LICENSURE |
| U1-0001454 | Other | DE | DELAWARE LICENSURE |
| OC010410 | Other | PA | OCCUPATIONAL THERAPY LICENSURE |
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 |
|---|---|---|---|
| U1-0001454 | DE | MD | Specialist |
| 46TR00443400 | NJ | MD | Specialist |
| OC010410 | PA | MD | Specialist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1197849600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1560470400000",
"number": "1730362450",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "600 GERMANTOWN PIKE STE A",
"city": "LAFAYETTE HILL",
"state": "PA",
"postal_code": "194441800",
"telephone_number": "215-290-0817"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "600 GERMANTOWN PIKE STE A",
"city": "LAFAYETTE HILL",
"state": "PA",
"postal_code": "19444",
"telephone_number": "215-290-0817"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MOLLO",
"first_name": "KIMBERLY",
"middle_name": "S",
"credential": "OTD, OTR/L",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-12-17",
"last_updated": "2019-06-14",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "DE",
"license": "U1-0001454",
"primary": false
},
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "NJ",
"license": "46TR00443400",
"primary": false
},
{
"code": "225XM0800X",
"taxonomy_group": "",
"desc": "Occupational Therapist, Mental Health",
"state": null,
"license": null,
"primary": false
},
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "PA",
"license": "OC010410",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NEW YORK LICENSE",
"identifier": "022381",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "OCCUPATIONAL THERAPY LICENSURE",
"identifier": "46TR00443400",
"state": "NJ"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DELAWARE LICENSURE",
"identifier": "U1-0001454",
"state": "DE"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "OCCUPATIONAL THERAPY LICENSURE",
"identifier": "OC010410",
"state": "PA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Lafayette Hill, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.