NPIMap

Organization Active NPI

Superstars Occupational Therapy for Kids, PLLC

  • Pediatric Occupational Therapist
  • Post Falls, ID
National Provider Identifier
1265698245
Registry record updated Jul 30, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Occupational TherapistTaxonomy code 225XP0200X
Legal business name
SUPERSTARS OCCUPATIONAL THERAPY FOR KIDS, PLLC
Practice address
2422 N. Partridge Loop
Post Falls, ID 83854-4944
Phone
(208) 819-9363
NPI assigned
Jul 30, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 30, 2008

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

Authorized official

Name
Kelly JohnsonNPI 1760501993
Title
Managing Member
Phone
(208) 819-9363

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Occupational TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225XP0200X Primary

Addresses

Primary practice location

2422 N. Partridge Loop
Post Falls, ID 83854-4944

Mailing address

2422 N. Partridge Loop
Post Falls, ID 83854-4944

National Provider Directory

National Provider Directory
Tax ID family
Superstars Occupational Therapy for Kids2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1217376000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1217376000000",
    "number": "1265698245",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2422 N. PARTRIDGE LOOP",
            "city": "POST FALLS",
            "state": "ID",
            "postal_code": "838544944"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2422 N. PARTRIDGE LOOP",
            "city": "POST FALLS",
            "state": "ID",
            "postal_code": "838544944",
            "telephone_number": "208-819-9363"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUPERSTARS OCCUPATIONAL THERAPY FOR KIDS, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-07-30",
        "last_updated": "2008-07-30",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "KELLY",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "208-819-9363"
    },
    "taxonomies": [
        {
            "code": "225XP0200X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Occupational Therapist, Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Post Falls, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2008; 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.