Individual provider Active NPI

Kaitlin Sorensen, MOTR/L

  • Occupational Therapist
  • Pocatello, ID
National Provider Identifier
1023553328
Registry record updated Dec 23, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
OT-1618 Issued in ID
Practice address
527 Memorial Dr
Pocatello, ID 83201-4063
Phone
(208) 478-3333
NPI assigned
Dec 23, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 23, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X OT-1618 ID Primary

Addresses

Primary practice location

527 Memorial Dr
Pocatello, ID 83201-4063

Mailing address

1250 E Center St
Pocatello, ID 83201-4701

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
OT-1618IDMDOccupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1482451200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1482451200000",
    "number": "1023553328",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1250 E CENTER ST",
            "city": "POCATELLO",
            "state": "ID",
            "postal_code": "832014701"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "527 MEMORIAL DR",
            "city": "POCATELLO",
            "state": "ID",
            "postal_code": "832014063",
            "telephone_number": "208-478-3333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SORENSEN",
        "first_name": "KAITLIN",
        "credential": "MOTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-12-23",
        "last_updated": "2016-12-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "ID",
            "license": "OT-1618",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pocatello, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 23, 2016; 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.