Individual provider Active NPI

Jacqueline K Schmidt, OT

  • Occupational Therapist
  • Shoreline, WA
National Provider Identifier
1336171685
Registry record updated Mar 3, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
7148825-4201 Issued in UT
Practice address
19930 Ballinger Way NE
Shoreline, WA 98155-1223
Phone
(206) 363-6947
NPI assigned
Jul 7, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 3, 2010

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 7148825-4201 UT Primary

Addresses

Primary practice location

19930 Ballinger Way NE
Shoreline, WA 98155-1223

Mailing address

2423 S 3300 W
Syracuse, UT 84075-5009

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
7148825-4201UTMDOccupational Therapist

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": "1267574400000",
    "number": "1336171685",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2423 S 3300 W",
            "city": "SYRACUSE",
            "state": "UT",
            "postal_code": "840755009"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19930 BALLINGER WAY NE",
            "city": "SHORELINE",
            "state": "WA",
            "postal_code": "981551223",
            "telephone_number": "206-363-6947"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHMIDT",
        "first_name": "JACQUELINE",
        "middle_name": "K",
        "credential": "OT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-07",
        "last_updated": "2010-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "UT",
            "license": "7148825-4201",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Shoreline, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2010; 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.