Kimberly Nicole Walker
Individual provider Active NPI Occupational Therapist · Elma, NY
NPI 1962275917 · NPPES record last updated Nov 1, 2023
Key facts
- NPI
- 1962275917
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Occupational Therapist 225X00000X
- Practice address
- 960 W Maple CT
Elma, NY 14059-9397 - Phone
- (716) 805-1555
- NPI assigned
- Nov 1, 2023
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare Care Compare profile
- Specialty
- Occupational Therapist in Private Practice
- Education
- Other, 2023
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Suburban Adult Services Inc.
Practice addresses (Care Compare)
960 W Maple CT
Elma, NY 14059-9397
Phone (716) 805-1440
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NY
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20231215000353 | NY | Practitioner - Occupational Therapist in Private Practice | 8527417559 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Suburban Adult Services-Inc. | Current |
Accepting new patients |
Locations
7030 Erie Rd
Derby, NY 14047
Phone (716) 947-5857
960 W Maple Ct
Elma, NY 14059
Phone (716) 805-1440
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | Yes |
Addresses
Primary practice location
960 W Maple CT
Elma, NY 14059-9397
Mailing address
960 W Maple CT
Elma, NY 14059-9397
NPI Registry JSON
{
"created_epoch": "1698796800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1698796800000",
"number": "1962275917",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "960 W MAPLE CT",
"city": "ELMA",
"state": "NY",
"postal_code": "140599397"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "960 W MAPLE CT",
"city": "ELMA",
"state": "NY",
"postal_code": "140599397",
"telephone_number": "716-805-1555"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WALKER",
"first_name": "KIMBERLY",
"middle_name": "NICOLE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-11-01",
"last_updated": "2023-11-01",
"certification_date": "2023-11-01",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Elma, NY
- Jennifer Tuberdyck
- Joan Ann Vivona
- Kiersten Voccola
- Andrew Howard Wagner
- Walgreen Co
- Brandy A Weber
- Bryan Wittmeyer
- Wny Spine & Sport Chiropractic, LLC
- Patricia Wraight
- Zelasko McCrea Chiropractic, PLLC
All providers in Elma, NY · Occupational Therapist in New York
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 1, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.