MEDICARE: JODY TINGELHOFF-HITCHCOCK

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225X00000X	Occupational Therapist	17-00528	KS

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	17-00528	OTHER	KS	KSBHA

General Provider Information

NPI Number	:	1225604242
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JODY TINGELHOFF-HITCHCOCK

Provider Business Mailing Address
First Line	:	3501 W 95TH ST
Second Line	:
City	:	OVERLAND PARK
State	:	KS
Zip	:	66206-2063
Country	:	US
Telephone Number	:	913-381-9530
Fax Number	:

Provider Business Practice Location Address
First Line	:	3501 W 95TH ST
Second Line	:
City	:	OVERLAND PARK
State	:	KS
Zip	:	66206-2063
Country	:	US
Telephone Number	:	913-381-9530
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/01/2021
Last Update Date	:	06/08/2026

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