Individual provider Active NPI

Kimberly Ann Olson, COTA/L

  • Occupational Therapy Assistant
  • Sun City, AZ
National Provider Identifier
1083904288
Registry record updated Apr 9, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Therapy AssistantTaxonomy code 224Z00000X
License
2296 Issued in AZ
Practice address
10032 N 109TH Ave
Sun City, AZ 85351-4323
Phone
(623) 974-4280
NPI assigned
Apr 9, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 9, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy Assistant 224Z00000X 2296 AZ Primary

Addresses

Primary practice location

10032 N 109TH Ave
Sun City, AZ 85351-4323

Mailing address

10032 N 109TH Ave
Sun City, AZ 85351-4323
Phone (623) 974-4280

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
2296AZMDOccupational Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1302307200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1302307200000",
    "number": "1083904288",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10032 N 109TH AVE",
            "city": "SUN CITY",
            "state": "AZ",
            "postal_code": "853514323",
            "telephone_number": "623-974-4280"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10032 N 109TH AVE",
            "city": "SUN CITY",
            "state": "AZ",
            "postal_code": "853514323",
            "telephone_number": "623-974-4280"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLSON",
        "first_name": "KIMBERLY",
        "middle_name": "ANN",
        "name_prefix": "Mrs.",
        "credential": "COTA/L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-04-09",
        "last_updated": "2011-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "AZ",
            "license": "2296",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sun City, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2011; 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.