Provider Demographics
NPI:1972749026
Name:KIPPINS, JONATHAN O (OTR/L)
Entity type:Individual
Prefix:MR
First Name:JONATHAN
Middle Name:O
Last Name:KIPPINS
Suffix:
Gender:M
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5705 BRYSON LN
Mailing Address - Street 2:
Mailing Address - City:LIBERTY TOWNSHIP
Mailing Address - State:OH
Mailing Address - Zip Code:45044-2523
Mailing Address - Country:US
Mailing Address - Phone:419-350-0029
Mailing Address - Fax:
Practice Address - Street 1:5705 BRYSON LN
Practice Address - Street 2:
Practice Address - City:LIBERTY TOWNSHIP
Practice Address - State:OH
Practice Address - Zip Code:45044-2523
Practice Address - Country:US
Practice Address - Phone:419-350-0029
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-12-19
Last Update Date:2025-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHOT.008361225XG0600X
OHOTA.03629224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XG0600XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGerontology
No224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant