Active NPI
Abby Grende
- Occupational Therapist
- Lewiston, ID
National Provider Identifier
1194156901
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- OT-1218
- Practice address
- 2831 Panorama Dr
Lewiston, ID 83501-1739 - Phone
- (701) 269-1133
- NPI assigned
- Dec 3, 2013
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | OT-1218 | ID | Primary |
| Occupational Therapist | 225X00000X | OT 60205352 | WA |
Addresses
Primary practice location
2831 Panorama Dr
Lewiston, ID 83501-1739
Mailing address
2831 Panorama Dr
Lewiston, ID 83501-1739
Phone (701) 269-1133
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| OT-1218 | ID | MD | Occupational Therapist |
| OT 60205352 | WA | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1386028800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1386028800000",
"number": "1194156901",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2831 PANORAMA DR",
"city": "LEWISTON",
"state": "ID",
"postal_code": "835011739",
"telephone_number": "701-269-1133"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2831 PANORAMA DR",
"city": "LEWISTON",
"state": "ID",
"postal_code": "835011739",
"telephone_number": "701-269-1133"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GRENDE",
"first_name": "ABBY",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2013-12-03",
"last_updated": "2013-12-03",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "ID",
"license": "OT-1218",
"primary": true
},
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "WA",
"license": "OT 60205352",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lewiston, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.