Individual provider Active NPI

Lynn Marie Herklotz, OTR

  • Occupational Therapist
  • Broomfield, CO
National Provider Identifier
1164172318
Registry record updated Mar 28, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
1662 Issued in CO
Practice address
17351 Drake St
Broomfield, CO 80023-5205
Phone
(303) 908-0500
Fax
(720) 465-9320
NPI assigned
Mar 28, 2022
Last updated
Mar 28, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 28, 2022

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 1662 CO Primary

Addresses

Primary practice location

17351 Drake St
Broomfield, CO 80023-5205

Mailing address

715 Merry LN
Boulder, CO 80303-9712
Phone (303) 931-3469

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220413001143 CO Practitioner - Occupational Therapist in Private Practice 6709272040 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Kind Rehabilitation LLCGroup PAC ID 9739421967, 9 clinicians

Practice addresses (Care Compare)

17351 Drake St
Broomfield, CO 80023-5205
Phone (303) 919-2324

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1662COMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Kind Rehabilitation LLC CurrentSince Mar 28, 2022 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1648425600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1648425600000",
    "number": "1164172318",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "715 MERRY LN",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803039712",
            "telephone_number": "303-931-3469"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17351 DRAKE ST",
            "city": "BROOMFIELD",
            "state": "CO",
            "postal_code": "800235205",
            "telephone_number": "303-908-0500",
            "fax_number": "720-465-9320"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERKLOTZ",
        "first_name": "LYNN",
        "middle_name": "MARIE",
        "credential": "OTR",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-03-28",
        "last_updated": "2022-03-28",
        "certification_date": "2022-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "CO",
            "license": "1662",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Broomfield, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.