Active NPI
Kimberley Marie Patterson, COTA
- Occupational Therapy Assistant
- Scotia, NY
National Provider Identifier
1912214396
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapy Assistant
- License
- 007590-1
- Practice address
- 175 Hetcheltown Rd
Scotia, NY 12302-5821 - Phone
- (518) 557-2792
- NPI assigned
- Sep 8, 2010
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapy Assistant | 224Z00000X | 007590-1 | NY | Primary |
Addresses
Primary practice location
175 Hetcheltown Rd
Scotia, NY 12302-5821
Mailing address
905 Southwest Ave Apt 5
Johnson City, TN 37604-6678
Phone (941) 587-8749
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
| License | State | Type | Specialty |
|---|---|---|---|
| 007590-1 | NY | MD | Occupational Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1283904000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1677456000000",
"number": "1912214396",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "905 SOUTHWEST AVE APT 5",
"city": "JOHNSON CITY",
"state": "TN",
"postal_code": "376046678",
"telephone_number": "941-587-8749"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "175 HETCHELTOWN RD",
"city": "SCOTIA",
"state": "NY",
"postal_code": "123025821",
"telephone_number": "518-557-2792"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PATTERSON",
"first_name": "KIMBERLEY",
"middle_name": "MARIE",
"name_prefix": "Ms.",
"credential": "COTA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2010-09-08",
"last_updated": "2023-02-27",
"certification_date": "2023-02-27",
"status": "A"
},
"taxonomies": [
{
"code": "224Z00000X",
"taxonomy_group": "",
"desc": "Occupational Therapy Assistant",
"state": "NY",
"license": "007590-1",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Scotia, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 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.