Nick Lane Chambard, OTR/L

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

OT.61137403 Issued in WA

Practice address

3927 Rucker Ave
Everett, WA 98201-4833

Phone

(425) 339-5470

Fax

(425) 317-4649

NPI assigned

Jan 25, 2021

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Nicholas Lane Chambard Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/3889/brand/1/csg/1/fhir/r4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

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  • NPI 1073944039
  NPD
• The Polyclinic PLLC

  dba Optum - Broadway

  • Audiologist
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  • NPI 1174594634
  NPD

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

{
    "created_epoch": "1611532800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1671408000000",
    "number": "1295325140",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5127",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982065127",
            "telephone_number": "425-304-8431"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3927 RUCKER AVE",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982014833",
            "telephone_number": "425-339-5470",
            "fax_number": "425-317-4649"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHAMBARD",
        "first_name": "NICK",
        "middle_name": "LANE",
        "credential": "OTR/L",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-01-25",
        "last_updated": "2022-12-19",
        "certification_date": "2022-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "WA",
            "license": "OT.61137403",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "NICHOLAS",
            "last_name": "CHAMBARD",
            "middle_name": "LANE",
            "credential": "OTR/L",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Kongkiat Chaikriangkrai, M.D.
• Chaison & Chaison DDS PLLC (Bothell Orthodontics)
• Sridar Chalaka, MD
• Kimberley Chalk, LMT
• Muhammed Cham
• Anne Elizabeth Chamberlain, MSN, ARNP
• Kaitlyn Marie Chamberlain, LMHC
• Leslie Chamberlain, PA-C
• Michelle Lynn Chamberlin
• Sarah Chamberlin, MSW

• Occupational Therapist in Everett, WA
• Providers in Everett, WA by specialty
• Occupational Therapist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2022; 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.