KERRY DIANNE MINDERMAN (NPI# 1942861117) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1942861117 |
| Entity Type | Individual |
| Full Name | KERRY DIANNE MINDERMAN |
| Practice Address |
4603 Timberwalk Ct La Grange KY 40031-6746 |
| Mailing Address |
438 Arlington Meadows Dr Fisherville KY 40023-7751 |
| Practice Telephone | 7038646695 |
| Mailing Telephone | 5025447777 |
| Enumeration Date | 2019-06-27 |
| Last Update Date | 2020-04-08 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 222Q00000X | Developmental Therapist | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Street Address |
4603 TIMBERWALK CT |
| City | LA GRANGE |
| State | KY |
| Zip Code | 40031-6746 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265574206 | Sally Ann Mccullum | Speech-Language Pathologist | 4603 Timberwalk Ct, La Grange, KY 40031-6746 | 2007-02-13 |
| 1609481407 | Alison Miles | Occupational Therapist | 4603 Timberwalk Ct, La Grange, KY 40031-6746 | 2020-09-09 |
| 1619581097 | Stacey Michelle Brothers | Developmental Therapist | 4603 Timberwalk Ct, La Grange, KY 40031-6746 | 2020-09-03 |
| 1427666379 | Kaitlyn King | Speech-Language Pathologist | 4603 Timberwalk Ct, La Grange, KY 40031-6746 | 2020-07-16 |
| 1861010415 | Jenna Conway | Speech-Language Pathologist | 4603 Timberwalk Ct, La Grange, KY 40031-6746 | 2020-07-10 |
| 1992323513 | Anna Jordyn Brown | Speech-Language Pathologist | 4603 Timberwalk Ct, La Grange, KY 40031-6746 | 2020-07-09 |
| 1952927154 | Jenna Collins | Speech-Language Pathologist | 4603 Timberwalk Ct, La Grange, KY 40031-6746 | 2020-06-23 |
| 1255953592 | Makenzi Janay Neal | Speech-Language Pathologist | 4603 Timberwalk Ct, La Grange, KY 40031-6746 | 2020-05-09 |
| 1144840471 | Sarah Elizebeth Strother | Speech-Language Pathologist | 4603 Timberwalk Ct, La Grange, KY 40031-6746 | 2020-04-16 |
| 1336774629 | Caitlin Shay Rothrock | Occupational Therapy Assistant | 4603 Timberwalk Ct, La Grange, KY 40031-6746 | 2020-03-06 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245723089 | Nancee L Berling | Registered Nurse | 1914 Miller Ln, La Grange, KY 40031 | 2018-06-06 |
| 1134643000 | Zachary Byrne | Dentist | 3108 S. Hwy 53, Lagrange, KY 40031 | 2017-08-01 |
| 1609399971 | Walgreen Co | Pharmacy | 408 Oldham Plaza, La Grange, KY 40031 | 2017-07-19 |
| 1447790886 | Carolyn Marie Burton | Speech-Language Pathologist | 4603 Timber Walk Ct., Lagrange, KY 40031 | 2017-03-05 |
| 1699145466 | Janet Frager | Nurse Practitioner | 1023 New Moody Ln Ste 101, La Grange, KY 40031 | 2015-10-05 |
| 1730559188 | Amanda Lynn Drawbaugh | Physical Therapist | Ascb Therapy, 4603 Timber Walk Ct., Lagrange, KY 40031 | 2015-09-29 |
| 1407250483 | Aaron Mangum | Specialist/Technologist | 2850 Jericho Road, Lagrange, KY 40031 | 2014-10-20 |
| 1073944500 | Tamara Thomas | Case Manager/Care Coordinator | 4121 Spencer Ct, Lagrange, KY 40031 | 2013-12-10 |
| 1669643854 | Alisa Marie Skinner | Physical Therapist | 618 Kentucky Ave, Lagrange, KY 40031 | 2008-03-17 |
| 1245410711 | Jennifer Lee Thomas | Nurse Practitioner | 1015 New Moody Lane, Lagrange, KY 40031 | 2007-11-13 |
| Find all providers in zip 40031 | ||||
| Taxonomy Code | 222Q00000X |
| Grouping | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Classification | Developmental Therapist |
| A Developmental Therapist is a person qualified by completion of an approved program in Developmental Therapy and where applicable credentialed by the state and practicing within the scope of the credential, or credentialed by completion of education experiences as approved by the state and practicing within the scope of that credential or, where state credentialing does not exist, certified by the Board of the Developmental Therapy Association. A developmental therapist evaluates children's global development in order to identify areas of developmental delay whether arising from physiological, neurological, or environmental factors, or a combination of factors; and designs, implements, and modifies therapeutic interventions for the child and the family to promote the child's acquisition of skills in a variety of developmental areas, including cognitive processes and social interaction in order to maximize functional independence and developmental homeostasis, and improve the quality of life at home and in the community; and provides consultation for the parents and other professionals working with the family on global development. |
| Notes: Source: The Illinois Developmental Therapists Association [1/1/2007: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205242179 | Tracy Michelle Webb | Developmental Therapist | 2220 Margate Ct, La Grange, KY 40031-8689 | 2014-07-10 |
| 1013322007 | Shannon Zimmer | Developmental Therapist | 54 Bluff Ave, La Grange, IL 60525-3678 | 2014-06-27 |
| 1073958625 | Michelle Marie Mcintosh | Developmental Therapist | 3711 Echo Valley Cir, La Grange, KY 40031-9644 | 2013-05-08 |
| 1205158052 | Jennifer Brennan | Developmental Therapist | 733 S La Grange Rd, La Grange, IL 60525-6726 | 2010-02-22 |
| 1467688432 | Paige Pontrelli | Developmental Therapist | 508 S La Grange Rd, La Grange, IL 60525-6732 | 2009-06-04 |
| 1851561450 | Jennifer Sims | Developmental Therapist | 424 East Ave, La Grange, IL 60525-6814 | 2008-03-11 |
| 1619581097 | Stacey Michelle Brothers | Developmental Therapist | 4603 Timberwalk Ct, La Grange, KY 40031-6746 | 2020-09-03 |
| 1497315782 | Shandela Hope Brewer | Developmental Therapist | 4603 Timberwalk Ct, La Grange, KY 40031-6746 | 2019-06-18 |
| 1467917302 | Nancy C Downs | Developmental Therapist | 4603 Timberwalk Ct, La Grange, KY 40031-6746 | 2019-02-05 |
| 1043789217 | Emily Janelle Pile | Developmental Therapist | 4603 Timberwalk Ct, La Grange, KY 40031-6746 | 2018-11-17 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.