Individual provider Active NPI

Kimberly Hughes, OTR

  • Occupational Therapist
  • Blue Ridge, GA
National Provider Identifier
1073674651
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
OT002105 Issued in GA
Practice address
3798 E First St
Blue Ridge, GA 30513-4514
Phone
(706) 632-7168
Fax
(706) 632-9756
NPI assigned
Dec 13, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 OT002105 GA Primary

Addresses

Primary practice location

3798 E First St
Blue Ridge, GA 30513-4514

Mailing address

1591 Walker Valley Rd NW
Cleveland, TN 37312-6465
Phone (423) 336-9827

Other identifiers 1

IdentifierTypeStateIssuer
00817429AMedicaidGA

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
OT002105GAMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Function Junction Inc Occupational Therapist Past Accepting new patients

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": "1165968000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1073674651",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1591 WALKER VALLEY RD NW",
            "city": "CLEVELAND",
            "state": "TN",
            "postal_code": "373126465",
            "telephone_number": "423-336-9827",
            "fax_number": "706-632-9756"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3798 E FIRST ST",
            "city": "BLUE RIDGE",
            "state": "GA",
            "postal_code": "305134514",
            "telephone_number": "706-632-7168",
            "fax_number": "706-632-9756"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUGHES",
        "first_name": "KIMBERLY",
        "credential": "OTR",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-12-13",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "GA",
            "license": "OT002105",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00817429A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Blue Ridge, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.