Individual provider Active NPI

Kathryn M Heermann, O.T.

  • Pediatric Occupational Therapist
  • Kalispell, MT
National Provider Identifier
1003962945
Registry record updated May 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Occupational TherapistTaxonomy code 225XP0200X
License
5498 Issued in MT
Practice address
80 Four Mile Dr Ste 14B
Kalispell, MT 59901-2665
Phone
(406) 252-6658
NPI assigned
Jan 25, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 13, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 5498 MT
Pediatric Occupational Therapist 225XP0200X 5498 MT Primary

Addresses

Primary practice location

80 Four Mile Dr Ste 14B
Kalispell, MT 59901-2665

Mailing address

185 Mannington St
Kalispell, MT 59901-8842
Phone (406) 261-3278

Other practice location 1

3335 Lt Moss Rd
Missoula, MT 59804-7222
Phone (406) 549-6413

Other practice location 2

185 Mannington St
Kalispell, MT 59901-8842
Phone (406) 261-0327

Other identifiers 1

IdentifierTypeStateIssuer
200005323MedicaidMT

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
5498MTMDPediatric Occupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
OT-Integrations, LLC Occupational Therapist CurrentSince Apr 1, 2024 Accepting new patients

Locations

80 Four Mile Dr
Ste 14B
Kalispell, MT 59901
Phone (406) 261-3823

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1169683200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715558400000",
    "number": "1003962945",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "185 MANNINGTON ST",
            "city": "KALISPELL",
            "state": "MT",
            "postal_code": "599018842",
            "telephone_number": "406-261-3278",
            "fax_number": "406-316-5893"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "80 FOUR MILE DR STE 14B",
            "city": "KALISPELL",
            "state": "MT",
            "postal_code": "599012665",
            "telephone_number": "406-252-6658"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3335 Lt Moss Rd",
            "address_purpose": "LOCATION",
            "city": "Missoula",
            "state": "MT",
            "postal_code": "598047222",
            "country_code": "US",
            "telephone_number": "406-549-6413",
            "fax_number": "406-549-6413",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "185 Mannington St",
            "address_purpose": "LOCATION",
            "city": "Kalispell",
            "state": "MT",
            "postal_code": "599018842",
            "country_code": "US",
            "telephone_number": "406-261-0327",
            "fax_number": "406-209-6244",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HEERMANN",
        "first_name": "KATHRYN",
        "middle_name": "M",
        "credential": "O.T.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-25",
        "last_updated": "2024-05-13",
        "certification_date": "2024-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "MT",
            "license": "5498",
            "primary": false
        },
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "MT",
            "license": "5498",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200005323",
            "state": "MT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kalispell, MT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.