Individual provider Active NPI

Kathlyn Rose Tiberi, OTR/L

  • Occupational Therapist
  • Oregon City, OR
National Provider Identifier
1851951628
Registry record updated May 4, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
489971 Issued in OR
Practice address
700 Molalla Ave
Oregon City, OR 97045-2652
Phone
(503) 666-1333
NPI assigned
Jun 14, 2019
Last updated
May 4, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 4, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 489971 OR Primary

Addresses

Primary practice location

700 Molalla Ave
Oregon City, OR 97045-2652

Mailing address

2 Jefferson Pkwy Apt J13
Lake Oswego, OR 97035-7870
Phone (951) 805-9119

Other practice location 1

304 NE Hood Ave
Gresham, OR 97030-7450
Phone (503) 666-1333

Other practice location 2

12900 SE 162nd Ave
Happy Valley, OR 97086-4741
Phone (503) 666-1333

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
489971ORMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Xcite Steps, LLC PastSince Aug 28, 2022 Accepting new patients
Pediatric Therapy Services Inc PastSince May 7, 2023 Accepting new patients

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1560470400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1683158400000",
    "number": "1851951628",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 JEFFERSON PKWY APT J13",
            "city": "LAKE OSWEGO",
            "state": "OR",
            "postal_code": "970357870",
            "telephone_number": "951-805-9119"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 MOLALLA AVE",
            "city": "OREGON CITY",
            "state": "OR",
            "postal_code": "970452652",
            "telephone_number": "503-666-1333"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "304 NE Hood Ave",
            "address_purpose": "LOCATION",
            "city": "Gresham",
            "state": "OR",
            "postal_code": "970307450",
            "country_code": "US",
            "telephone_number": "503-666-1333",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "12900 SE 162nd Ave",
            "address_purpose": "LOCATION",
            "city": "Happy Valley",
            "state": "OR",
            "postal_code": "970864741",
            "country_code": "US",
            "telephone_number": "503-666-1333",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TIBERI",
        "first_name": "KATHLYN",
        "middle_name": "ROSE",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-06-14",
        "last_updated": "2023-05-04",
        "certification_date": "2023-05-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "OR",
            "license": "489971",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oregon City, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 4, 2023; 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.