Individual provider Active NPI

Kimberly Hofbauer, COTA/L

  • Occupational Therapy Assistant
  • Sylvania, OH
National Provider Identifier
1801216015
Registry record updated Apr 27, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Therapy AssistantTaxonomy code 224Z00000X
License
OTA.04695 Issued in OH
Practice address
5220 Alexis Rd
Sylvania, OH 43560-2504
Phone
(419) 318-5700
NPI assigned
Apr 27, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 27, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy Assistant 224Z00000X OTA.04695 OH Primary

Addresses

Primary practice location

5220 Alexis Rd
Sylvania, OH 43560-2504

Mailing address

5220 Alexis Rd
Sylvania, OH 43560-2504

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

LicenseStateTypeSpecialty
OTA.04695OHMDOccupational Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1398556800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1398556800000",
    "number": "1801216015",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5220 ALEXIS RD",
            "city": "SYLVANIA",
            "state": "OH",
            "postal_code": "435602504"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5220 ALEXIS RD",
            "city": "SYLVANIA",
            "state": "OH",
            "postal_code": "435602504",
            "telephone_number": "419-318-5700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOFBAUER",
        "first_name": "KIMBERLY",
        "credential": "COTA/L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-04-27",
        "last_updated": "2014-04-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "OH",
            "license": "OTA.04695",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sylvania, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 2014; 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.