Kimberly Hrobak Bumgardner, OTR/L

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

2610 Issued in SC

Practice address

1099 Edgewater Corporate Pkwy Ste B
Indian Land, SC 29707-4516

Phone

(803) 929-7408

NPI assigned

Apr 8, 2009

Last updated

Oct 27, 2021By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in SC, NC2 enrollments

Enrollment records 2

Specialty

Occupational Therapist in Private Practice

Education

Nova Southeastern College of Osteo Medicine, 2001

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Collective Therapy CorpGroup PAC ID 0143651802, 75 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Collective Therapy Corp.

  • Speech-Language Pathologist
  • Charlotte, NC
  • NPI 1396380911

  Occupational Therapist, SC

  Medicare reassignment Care Compare group NPD
• Charlotte Neuroscience Foundation

  dba Memory & Movement Charlotte

  • Neurology Physician
  • Charlotte, NC
  • NPI 1508394750
  NPD (past)

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

{
    "created_epoch": "1239148800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635292800000",
    "number": "1346483229",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1165 WESSINGTON MANOR LN STE 200",
            "city": "FORT MILL",
            "state": "SC",
            "postal_code": "297157806",
            "telephone_number": "205-908-7894"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1099 EDGEWATER CORPORATE PKWY STE B",
            "city": "INDIAN LAND",
            "state": "SC",
            "postal_code": "297074516",
            "telephone_number": "803-929-7408"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUMGARDNER",
        "first_name": "KIMBERLY",
        "middle_name": "HROBAK",
        "name_prefix": "Mrs.",
        "credential": "OTR/L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-04-08",
        "last_updated": "2021-10-27",
        "certification_date": "2021-10-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "AL",
            "license": "2542",
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "SC",
            "license": "2610",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jessica Bradburn, DC
• Brain Restoration Clinic, PLLC
• Renee E Brassell, RN
• Kacie A Breault, OD
• Kerry Patterson Briones, MD
• George Archibald Butler, MD
• Colleen Marie Caffrey-Thrasher, LAC. DIPLAC, MAC
• Stephen Calderalo
• Calloway Primary Care & Wellness LLC
• Cassandra Nicole Calloway, FNP

• Occupational Therapist in Indian Land, SC
• Providers in Indian Land, SC by specialty
• Occupational Therapist in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2021; 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.