Individual provider Active NPI

Kristen Marie Brokamp, OTR/L

  • Occupational Therapist
  • Cincinnati, OH
National Provider Identifier
1912367624
Registry record updated May 30, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
OT009258 Issued in OH
Practice address
2605 Ida Ave
Cincinnati, OH 45212-4213
Phone
(513) 549-2128
NPI assigned
Feb 24, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 30, 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 OT009258 OH Primary

Addresses

Primary practice location

2605 Ida Ave
Cincinnati, OH 45212-4213

Mailing address

2234 Kemper LN
Cincinnati, OH 45206-2719
Phone (513) 518-3194

Other practice location 1

4440 Carver Woods Dr
Blue Ash, OH 45242-5529
Phone (513) 791-5688

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230621002136 OH Practitioner - Occupational Therapist in Private Practice 3779941810 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Hearing Speech and Deaf Center of Greater Cincinnati CurrentSince Jul 1, 2023 Accepting new patients

Locations

4440 Carver Woods Dr
Blue Ash, OH 45242
Phone (513) 771-7655

2825 Burnet Ave
Ste 330
Cincinnati, OH 45219
Phone (513) 221-0527

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1456272000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1685404800000",
    "number": "1912367624",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2234 KEMPER LN",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452062719",
            "telephone_number": "513-518-3194"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2605 IDA AVE",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452124213",
            "telephone_number": "513-549-2128"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4440 Carver Woods Dr",
            "address_purpose": "LOCATION",
            "city": "Blue Ash",
            "state": "OH",
            "postal_code": "452425529",
            "country_code": "US",
            "telephone_number": "513-791-5688",
            "fax_number": "513-791-0023",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BROKAMP",
        "first_name": "KRISTEN",
        "middle_name": "MARIE",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-02-24",
        "last_updated": "2023-05-30",
        "certification_date": "2023-05-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "OH",
            "license": "OT009258",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cincinnati, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 30, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.