HOLLY BROACH (NPI# 1992123608) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1992123608 |
| Entity Type | Individual |
| Full Name | HOLLY BROACH |
| Credential | OTR/L |
| Practice Address |
580 Lincoln Park Blvd Kettering OH 45429-3474 |
| Mailing Address |
5433 Red Coach Rd Centerville OH 45429-6113 |
| Practice Telephone | 9374991400 |
| Mailing Telephone | 9378382366 |
| Enumeration Date | 2014-03-31 |
| Last Update Date | 2020-01-09 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 224Z00000X | Occupational Therapy Assistant | OTA 02967 | OH | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Y | 225X00000X | Occupational Therapist | 008756 | OH | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Street Address |
580 LINCOLN PARK BLVD |
| City | KETTERING |
| State | OH |
| Zip Code | 45429-3474 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831177872 | Jeffrey Keith Hoffman | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 580 Lincoln Park Blvd, Suite 322, Kettering, OH 45429-3474 | 2006-01-09 |
| 1063870699 | Interventional Pathology of Ohio LLC | Pathology | 580 Lincoln Park Blvd, 344, Kettering, OH 45429-3474 | 2016-02-10 |
| 1518283712 | Premier Health Specialists Inc | Surgery | 580 Lincoln Park Blvd, Suite 300, Kettering, OH 45429-3474 | 2010-04-13 |
| 1548400880 | Sharon Halter | Perfusionist | 580 Lincoln Park Blvd, Suite 322, Kettering, OH 45429-3474 | 2009-02-26 |
| 1265672505 | Douglas Tidwell | Perfusionist | 580 Lincoln Park Blvd, Suite 322, Kettering, OH 45429-3474 | 2009-02-26 |
| 1306091350 | Aaron Joseph Siefker | Perfusionist | 580 Lincoln Park Blvd, Suite 322, Kettering, OH 45429-3474 | 2008-11-18 |
| 1124272976 | Sunishka M Wimalawansa | Surgery | 580 Lincoln Park Blvd, Suite 255, Kettering, OH 45429-3474 | 2008-11-06 |
| 1871788315 | Ramic Kettering, L.L.C. | Clinic/Center | 580 Lincoln Park Blvd, Suite 100, Kettering, OH 45429-3474 | 2007-09-07 |
| 1154451185 | Deborah W Serenius | Dietitian, Registered | 580 Lincoln Park Blvd, Suite 266, Kettering, OH 45429-3474 | 2007-03-07 |
| 1205948452 | Michael T La Nou | Physician Assistant | 580 Lincoln Park Blvd, Suite 322, Kettering, OH 45429-3474 | 2006-08-31 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821576414 | Lauren Danielle Sivley | Nurse Practitioner | 3535 Sourthern Boulevard, Kettering, OH 45429 | 2018-08-06 |
| 1114446127 | Louai Al-samkari | Chiropractor | 1441 E. Stroop Rd., Kettering, OH 45429 | 2017-09-12 |
| 1407373756 | Benjamin Edward Adkins | Specialist/Technologist | 4116 Vinita Dr., Kettering, OH 45429 | 2017-08-28 |
| 1972036341 | James Kim | Student in an Organized Health Care Education/Training Program | 3535 Southern Boulevard, Kettering, OH 45429 | 2017-04-04 |
| 1023549847 | Adrienne Krysiak | Emergency Medicine | 3525 Southern Boulevard, Kettering, OH 45429 | 2017-03-23 |
| 1386021889 | Cassandra Mckoy | Counselor | 529 East Stroop Road, Kettering, OH 45429 | 2015-05-04 |
| 1417343088 | Candace Benoit | Obstetrics & Gynecology | 3533 Southern Blvd Ste 4600, Dayton, OH 45429 | 2015-04-10 |
| 1275933574 | Lee Schwieterman | Nurse Practitioner | 3535 Southern Blvd., 1 East, Kettering, OH 45429 | 2014-08-25 |
| 1497161947 | Robert Jonathon Fresch Jr. | Obstetrics & Gynecology | 3533 Southern Blvd Ste 3750, Kettering, OH 45429 | 2014-07-05 |
| 1821349812 | Lucas Brewer | Counselor | 1524 E Stroop Rd Ste 300, Kettering, OH 45429 | 2012-10-01 |
| Find all providers in zip 45429 | ||||
| Taxonomy Code | 225X00000X |
| Grouping | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Classification | Occupational Therapist |
| An occupational therapist is a person who has graduated from an entry-level occupational therapy program accredited by the Accreditation Council for Occupational Therapy Education (ACOTE) or predecessor organizations, or approved by the World Federation of Occupational Therapists (WFOT), or an equivalent international occupational therapy education program; has successfully completed a period of supervised fieldwork experience required by the occupational therapy program; has passed a nationally recognized entry-level examination for occupational therapists, and fulfills state requirements for licensure, certification, or registration. An occupational therapist provides interventions based on evaluation and which emphasize the therapeutic use of everyday life activities (i.e., occupations) with individuals or groups for the purpose of facilitating participation in roles and situations and in home, school, workplace, community and other settings. Occupational therapy services are provided for the purpose of promoting health and wellness and are provided to those who have or are at risk for developing an illness, injury, disease, disorder, condition, impairment, disability, activity limitation, or participation restriction. Occupational therapists address the physical, cognitive, psychosocial, sensory, and other aspects of occupational performance in a variety of contexts to support engagement in everyday life activities that affect health, well-being, and quality of life. |
| Notes: Source: The Guide to Occupational Therapy Practice, 2nd edition. Bethesda: American Occupational Therapy Association, 2007. [7/1/2008: definition changed, added source] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881881720 | Edwin Jay Myers | Occupational Therapist | 2216 Culver Ave, Kettering, OH 45420-1328 | 2007-09-25 |
| 1104035815 | Karla Anne Hoppe | Occupational Therapist | 3000 Glengarry Dr, Kettering, OH 45420-1227 | 2007-05-21 |
| 1811479256 | Calliope Joon Gray | Occupational Therapist | 5070 Lamme Rd, Kettering, OH 45439 | 2018-09-02 |
| 1235559543 | Blythe Isenburg | Occupational Therapist | 3000 Glengarry Dr, Kettering, OH 45420-1227 | 2014-04-25 |
| 1972760221 | Mary Lou O'malley | Occupational Therapist | 3122 Wilmington Pike, Kettering, OH 45429-4004 | 2008-05-22 |
| 1013195676 | Desiree Carolina Hardwick | Occupational Therapist | 3122 Wilmington Pike, Kettering, OH 45429-4004 | 2008-02-06 |
| 1497880488 | Maria Floyd | Occupational Therapist | 3122 Wilmington Pike, Kettering, OH 45429-4004 | 2007-02-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972104891 | Erin Camille Rowan | Occupational Therapist | 599 Harry Sauner Rd Ste B, Hillsboro, OH 45133-7631 | 2020-11-06 |
| 1902407471 | Alexander Orkwis | Occupational Therapist | 9826 Summers Pond Dr, Loveland, OH 45140-5677 | 2020-11-02 |
| 1639779507 | Rachel Sparks | Occupational Therapist | 4170 Allium Ct, Springfield, OH 45505-1664 | 2020-10-29 |
| 1447859269 | Elisabeth K Yoder | Occupational Therapist | 100 Huskies Way, Cadiz, OH 43907-1257 | 2020-10-22 |
| 1023617792 | Kylee Nicole Grady | Occupational Therapist | 21475 Hillsdale Ave, Fairview Park, OH 44126-2118 | 2020-10-22 |
| 1710584347 | Kristin Elizabeth Hazlett | Occupational Therapist | 31506 Fairwin Dr, Bay Village, OH 44140-1445 | 2020-10-06 |
| 1902403629 | Leah Daniel | Occupational Therapist | 1114 Neighborhood Dr, Batavia, OH 45103-2874 | 2020-10-06 |
| 1538775432 | Alli Hall | Occupational Therapist | 289 Euclid Ave, Delaware, OH 43015-1272 | 2020-09-17 |
| 1053927855 | Julissa Uchaker | Occupational Therapist | 20400 Arbor Ave, Euclid, OH 44123-3160 | 2020-09-17 |
| 1063028082 | Christina Marrero | Occupational Therapist | 103 Shepherd Dr, Tiffin, OH 44883-2969 | 2020-09-16 |
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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.