Individual provider Active NPI

Kenzi Kuemper

  • Occupational Therapist
  • Liberty Lake, WA
National Provider Identifier
1346077153
Registry record updated Sep 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
61592800 Issued in WA
Practice address
21651 E Country Vista Dr
Liberty Lake, WA 99019-7708
Phone
(509) 822-7834
NPI assigned
Sep 16, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 16, 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 61592800 WA Primary

Addresses

Primary practice location

21651 E Country Vista Dr
Liberty Lake, WA 99019-7708

Mailing address

21651 E Country Vista Dr
Liberty Lake, WA 99019-7708
Phone (509) 822-7834

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241003001904 WA Practitioner - Occupational Therapist in Private Practice 1153852918 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lake City Physical Therapy P aGroup PAC ID 3678465234, 13 clinicians

Practice addresses (Care Compare)

3009 S Grand Blvd
Spokane, WA 99203-2559
Phone (509) 868-0849

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
61592800WAMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Lake City Physical Therapy P a Occupational Therapist CurrentSince Sep 24, 2024 Accepting new patients
Advanced Physical Therapy Inc Past Accepting new patients

Locations

2170 W Ironwood Center Dr
Ste B
Coeur D Alene, ID 83814
Phone (208) 667-1988

21651 E Country Vista Dr
Liberty Lake, WA 99019
Phone (509) 598-9402

3009 S Grand Blvd
Spokane, WA 99203
Phone (208) 966-4176

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1726444800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726444800000",
    "number": "1346077153",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21651 E COUNTRY VISTA DR",
            "city": "LIBERTY LAKE",
            "state": "WA",
            "postal_code": "990197708",
            "telephone_number": "509-822-7834"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21651 E COUNTRY VISTA DR",
            "city": "LIBERTY LAKE",
            "state": "WA",
            "postal_code": "990197708",
            "telephone_number": "509-822-7834"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUEMPER",
        "first_name": "KENZI",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-09-16",
        "last_updated": "2024-09-16",
        "certification_date": "2024-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "WA",
            "license": "61592800",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Liberty Lake, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.