Individual provider Active NPI

Kendall Noelle Jo, OTR/L

  • Hand Occupational Therapist
  • Frederick, MD
National Provider Identifier
1750112025
Registry record updated Jan 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hand Occupational TherapistTaxonomy code 225XH1200X
License
10333 Issued in MD
Practice address
8420 Gas House Pike Ste U
Frederick, MD 21701-4974
Phone
(240) 651-0149
Fax
(240) 559-2624
NPI assigned
Aug 9, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 2, 2025

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 10333 MD Primary

Addresses

Primary practice location

8420 Gas House Pike Ste U
Frederick, MD 21701-4974

Mailing address

8420 Gas House Pike Ste U
Frederick, MD 21701-4974
Phone (240) 651-0149

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250513001209 MD Practitioner - Occupational Therapist in Private Practice 7214455328 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Leadbetter Rehabilitation LLCGroup PAC ID 8921382995, 7 clinicians

Practice addresses (Care Compare)

8420 Gas House Pike
Suite U
Frederick, MD 21701-4974
Phone (240) 651-0149

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
10333MDMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Leadbetter Rehabilitation, LLC Hand CurrentSince Mar 7, 2025 Accepting new patients
Leadbetter Rehabilitation, LLC CurrentSince Nov 8, 2025 Accepting new patients

Locations

8420 Gas House Pike
Ste U
Frederick, MD 21701
Phone (240) 559-2624

Organizations & group practices 2

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": "1723161600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1735776000000",
    "number": "1750112025",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8420 GAS HOUSE PIKE STE U",
            "city": "FREDERICK",
            "state": "MD",
            "postal_code": "217014974",
            "telephone_number": "240-651-0149"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8420 GAS HOUSE PIKE STE U",
            "city": "FREDERICK",
            "state": "MD",
            "postal_code": "217014974",
            "telephone_number": "240-651-0149",
            "fax_number": "240-559-2624"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JO",
        "first_name": "KENDALL",
        "middle_name": "NOELLE",
        "credential": "OTR/L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-08-09",
        "last_updated": "2025-01-02",
        "certification_date": "2025-01-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XH1200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Hand",
            "state": "MD",
            "license": "10333",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Frederick, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 2, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.