Individual provider Active NPI

Kim Vonk

  • Hand Occupational Therapist
  • La Mesa, CA
National Provider Identifier
1235727132
Registry record updated Jan 6, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hand Occupational TherapistTaxonomy code 225XH1200X
Practice address
5905 Severin Dr.
La Mesa, CA 91942-3806
Phone
(619) 589-2606
NPI assigned
Jan 6, 2021
Last updated
Jan 6, 2021By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 6, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hand Occupational Therapist 225XH1200X NU Primary

Addresses

Primary practice location

5905 Severin Dr.
La Mesa, CA 91942-3806

Mailing address

5810 Amaya Dr Apt 17D
La Mesa, CA 91942-4140
Phone (619) 339-7368

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210324001342 CA Practitioner - Occupational Therapist in Private Practice 6709293467 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

5905 Severin Dr
La Mesa, CA 91942-3806
Phone (619) 589-2606

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Eggleton & Langton Physical Therapy Management Services CurrentSince Mar 3, 2024 Accepting new patients
Eggleton Langton Physical Therapy Management Services Past Accepting new patients
Eggleton & Langton Physical Therapy Management Services Past Accepting new patients

Locations

5905 Severin Dr
La Mesa, CA 91942
Phone (619) 589-2606

2600 Dallas Pkwy
Ste 290
Frisco, TX 75034
Phone (945) 260-0010

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 4

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": "1609891200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1609891200000",
    "number": "1235727132",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5810 AMAYA DR APT 17D",
            "city": "LA MESA",
            "state": "CA",
            "postal_code": "919424140",
            "telephone_number": "619-339-7368"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5905 SEVERIN DR.",
            "city": "LA MESA",
            "state": "CA",
            "postal_code": "919423806",
            "telephone_number": "619-589-2606"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VONK",
        "first_name": "KIM",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-01-06",
        "last_updated": "2021-01-06",
        "certification_date": "2021-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XH1200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Hand",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in La Mesa, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 2021; 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.