Individual provider Active NPI

Corbett Dean Mercer, OTR

  • Physical Rehabilitation Occupational Therapist
  • Kirkland, WA
National Provider Identifier
1083475982
Registry record updated Jan 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Rehabilitation Occupational TherapistTaxonomy code 225XP0019X
License
OT60867391 Issued in WA
Practice address
11800 NE 128TH St Ste 200
Kirkland, WA 98034-7211
Phone
(425) 899-3300
NPI assigned
Jan 17, 2024
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 17, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Rehabilitation Occupational Therapist 225XP0019X OT60867391 WA Primary

Addresses

Primary practice location

11800 NE 128TH St Ste 200
Kirkland, WA 98034-7211

Mailing address

300 Lenora St # 739
Seattle, WA 98121-2411
Phone (802) 782-4604

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
OT60867391WAMDPhysical Rehabilitation Occupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1705449600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705449600000",
    "number": "1083475982",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 LENORA ST # 739",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981212411",
            "telephone_number": "802-782-4604"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11800 NE 128TH ST STE 200",
            "city": "KIRKLAND",
            "state": "WA",
            "postal_code": "980347211",
            "telephone_number": "425-899-3300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MERCER",
        "first_name": "CORBETT",
        "middle_name": "DEAN",
        "name_prefix": "Mr.",
        "credential": "OTR",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-01-17",
        "last_updated": "2024-01-17",
        "certification_date": "2024-01-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XP0019X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Physical Rehabilitation",
            "state": "WA",
            "license": "OT60867391",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kirkland, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 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.