Kidshine LLC

Primary specialty

Developmental Disabilities Clinic/CenterTaxonomy code 261QD1600X

License

7585 Issued in MA

Legal business name

KIDSHINE LLC

Practice address

75 Turnpike Rd # 3C
Ipswich, MA 01938-1046

Phone

(978) 356-0315

Fax

(978) 356-0316

NPI assigned

Nov 12, 2015

Organization subpart

No

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

Authorized official

Name

Ms. Amy C Wheadon, MS, OTR/LNPI 1366864472

Title

Owner

Phone

(781) 367-9729

Specialties & licenses 2

Addresses

Tax ID family

Kidshine LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Kidshine LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Rowley, MA
  • NPI 1790658185
  NPD tax ID

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Amy Wheadon, MS, OTR/L

  • Pediatric Occupational Therapist
  • Danvers, MA
  • NPI 1366864472
  NPD Authorized official
• Suzanne Mary Jobski, OTD, OTR/L

  • Pediatric Occupational Therapist
  • Ipswich, MA
  • NPI 1639630650
  NPD (past)
• Brianna Katherine Worcester, M.S., OTR/L

  • Pediatric Occupational Therapist
  • Bedford, NH
  • NPI 1477037356
  NPD (past)

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

{
    "created_epoch": "1447286400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1557878400000",
    "number": "1831562891",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "75 TURNPIKE RD # 3C",
            "city": "IPSWICH",
            "state": "MA",
            "postal_code": "019381046",
            "telephone_number": "978-356-0315",
            "fax_number": "978-356-0316"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "75 TURNPIKE RD # 3C",
            "city": "IPSWICH",
            "state": "MA",
            "postal_code": "019381046",
            "telephone_number": "978-356-0315",
            "fax_number": "978-356-0316"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "31 Pye Brook Ln",
            "address_purpose": "LOCATION",
            "city": "Boxford",
            "state": "MA",
            "postal_code": "019211819",
            "country_code": "US",
            "telephone_number": "781-367-9729",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "KIDSHINE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-11-12",
        "last_updated": "2019-05-15",
        "status": "A",
        "authorized_official_last_name": "WHEADON",
        "authorized_official_first_name": "AMY",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "781-367-9729",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "MS, OTR/L"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QD1600X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Developmental Disabilities",
            "state": "MA",
            "license": "7585",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• KCS, LLC
• Julia Kell
• Rita V Kelleher, OTR/L
• Zoe Kessler
• Sunidhi Khuteta
• Matthew William Knight, D.D.S.
• Joel M Kobey, LMHC
• Estelle Nicole Krause
• Kendall Kravchuk
• Harlan Justin Kroff, LMHC

• Developmental Disabilities Clinic/Center in Ipswich, MA
• Providers in Ipswich, MA by specialty
• Developmental Disabilities Clinic/Center in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 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.

Verify at the official NPI Registry.