Individual provider Active NPI

Joann L Keller, OT

  • Occupational Therapist
  • Lynnwood, WA
National Provider Identifier
1326070780
Registry record updated Oct 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
Practice address
19203 36TH Ave W Ste 103
Lynnwood, WA 98036-5772
Phone
(425) 368-7943
Fax
(425) 368-7443
NPI assigned
Jul 7, 2006
Last updated
Oct 10, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 10, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X NU Primary

Addresses

Primary practice location

19203 36TH Ave W Ste 103
Lynnwood, WA 98036-5772

Mailing address

19203 36TH Ave W Ste 103
Lynnwood, WA 98036-5772
Phone (425) 368-7943

Other names 1

  • Joann K Green Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120214000249 WA Practitioner - Occupational Therapist in Private Practice 3870539653 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Hand Therapy Northwest Inc Occupational Therapist CurrentSince Nov 1, 2011 Accepting new patients
Hands for Living LLC Occupational Therapist CurrentSince Jan 1, 2011 Accepting new patients

Locations

19203 36th Ave W
Ste 103
Lynnwood, WA 98036
Phone (425) 368-7943

19221 36th Ave W
Ste 213
Lynnwood, WA 98036
Phone (425) 368-7943

16150 NE 85th St
Ste 116
Redmond, WA 98052
Phone (425) 881-1921

Organizations & group practices 2

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": "1152230400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728518400000",
    "number": "1326070780",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19203 36TH AVE W STE 103",
            "city": "LYNNWOOD",
            "state": "WA",
            "postal_code": "980365772",
            "telephone_number": "425-368-7943",
            "fax_number": "425-368-5236"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19203 36TH AVE W STE 103",
            "city": "LYNNWOOD",
            "state": "WA",
            "postal_code": "980365772",
            "telephone_number": "425-368-7943",
            "fax_number": "425-368-7443"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLER",
        "first_name": "JOANN",
        "middle_name": "L",
        "credential": "OT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-07",
        "last_updated": "2024-10-10",
        "certification_date": "2024-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JOANN",
            "last_name": "GREEN",
            "middle_name": "K",
            "credential": "OT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Lynnwood, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.