Kim Green Occupational Therapy, PC

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

006484 Issued in NY

Legal business name

KIM GREEN OCCUPATIONAL THERAPY, PC

Doing business as

Green Rehabilitation & Injury Management

Practice address

104 Clinton St
Fayetteville, NY 13066-2045

Phone

(315) 637-0035

Fax

(315) 637-1335

NPI assigned

Aug 1, 2007

Organization subpart

No

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

Authorized official

Name

Ms. Kimberly C Green, OTR/L

Title

Occupational Therapist/Owner

Phone

(315) 637-0035

Specialties & licenses 1

Addresses

Other names 1

• Green Rehabilitation & Injury Management Doing business as

Locations

Practitioners 1

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

• Johanna Whitney Povlock, OTR/L

  • Occupational Therapist
  • Memphis, NY
  • NPI 1366551491
  NPD (past)

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

{
    "created_epoch": "1185926400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1384905600000",
    "number": "1851581151",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "104 CLINTON ST",
            "city": "FAYETTEVILLE",
            "state": "NY",
            "postal_code": "130662045",
            "telephone_number": "315-637-0035",
            "fax_number": "315-637-1335"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "104 CLINTON ST",
            "city": "FAYETTEVILLE",
            "state": "NY",
            "postal_code": "130662045",
            "telephone_number": "315-637-0035",
            "fax_number": "315-637-1335"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KIM GREEN OCCUPATIONAL THERAPY, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-01",
        "last_updated": "2013-11-20",
        "status": "A",
        "authorized_official_last_name": "GREEN",
        "authorized_official_first_name": "KIMBERLY",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "OCCUPATIONAL THERAPIST/OWNER",
        "authorized_official_telephone_number": "315-637-0035",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "OTR/L"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Occupational Therapist",
            "state": "NY",
            "license": "006484",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Green Rehabilitation & Injury Management",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Kimberly Keene, LMSW
• Gregory G Kenien, MD
• Megan E Kernan, PT, DPT
• Sarah Elizabeth Keyes, AUD
• Sheryl L Khan, RPA
• Bokkyu Kim, PT, PHD
• Ju Yeon Kim
• Brian R Kline, MD
• Chelsea Klock, FNP-C
• Jessica Amanda Knapp, PT

• Occupational Therapist in Fayetteville, NY
• Providers in Fayetteville, NY by specialty
• Occupational Therapist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2013; 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.