Organization Active NPI

Kerin Graham OT

  • Occupational Therapist
  • North Conway, NH
National Provider Identifier
1275803884
Registry record updated Jan 12, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
1569 Issued in NH
Legal business name
KERIN GRAHAM OT
Practice address
170 Kearsarge Rd
North Conway, NH 03860-5331
Phone
(603) 356-4114
Fax
(603) 356-4118
NPI assigned
Jan 12, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 12, 2012

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

Authorized official

Name
Kerin Graham, MSOT
Title
Occupational Therapist
Phone
(603) 356-4114

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225X00000X 1569 NH Primary

Addresses

Primary practice location

170 Kearsarge Rd
North Conway, NH 03860-5331

Mailing address

PO Box 583
Intervale, NH 03845-0583
Phone (603) 356-4114

Other identifiers 1

IdentifierTypeStateIssuer
30417929MedicaidNH

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1326326400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1326326400000",
    "number": "1275803884",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 583",
            "city": "INTERVALE",
            "state": "NH",
            "postal_code": "038450583",
            "telephone_number": "603-356-4114",
            "fax_number": "603-356-4118"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "170 KEARSARGE RD",
            "city": "NORTH CONWAY",
            "state": "NH",
            "postal_code": "038605331",
            "telephone_number": "603-356-4114",
            "fax_number": "603-356-4118"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KERIN GRAHAM OT",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-01-12",
        "last_updated": "2012-01-12",
        "status": "A",
        "authorized_official_last_name": "GRAHAM",
        "authorized_official_first_name": "KERIN",
        "authorized_official_title_or_position": "OCCUPATIONAL THERAPIST",
        "authorized_official_telephone_number": "603-356-4114",
        "authorized_official_credential": "MSOT"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Occupational Therapist",
            "state": "NH",
            "license": "1569",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30417929",
            "state": "NH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in North Conway, NH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2012; 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.