Individual provider Active NPI

Karen Nishimura, OT

  • Specialist
  • Carlsbad, CA
National Provider Identifier
1356451298
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
OT6467 Issued in CA
Practice address
7760 El Camino Real
Carlsbad, CA 92009-8553
Phone
(760) 634-9750
Fax
(760) 634-9752
NPI assigned
Aug 30, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X OT6467 CA Primary

Addresses

Primary practice location

7760 El Camino Real
Carlsbad, CA 92009-8553

Mailing address

7760 El Camino Real
Carlsbad, CA 92009-8553
Phone (760) 634-9750

Other identifiers 1

IdentifierTypeStateIssuer
OT6467OtherCAOT LICENSE #

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040204000606 CA Practitioner - Occupational Therapist in Private Practice 0648163683 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OT6467CAMDSpecialist

Practice roles

OrganizationSpecialtyStatusNew patients
Del Dios Therapy, LLC CurrentSince Dec 16, 2024 Accepting new patients
Gaspar Physical Therapy Specialist Past Accepting new patients
Levas Physical & Occupational Therapy Past Accepting new patients
Gaspar Physical Therapy a Professional Corporation Specialist Past Accepting new patients

Locations

1817 Avenida del Diablo
Escondido, CA 92029
Phone (442) 277-0190

Organizations & group practices 4

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": "1156896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1356451298",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7760 EL CAMINO REAL",
            "city": "CARLSBAD",
            "state": "CA",
            "postal_code": "920098553",
            "telephone_number": "760-634-9750",
            "fax_number": "760-634-9752"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7760 EL CAMINO REAL",
            "city": "CARLSBAD",
            "state": "CA",
            "postal_code": "920098553",
            "telephone_number": "760-634-9750",
            "fax_number": "760-634-9752"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NISHIMURA",
        "first_name": "KAREN",
        "credential": "OT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-30",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "CA",
            "license": "OT6467",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OT LICENSE #",
            "identifier": "OT6467",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Carlsbad, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.