Individual provider Active NPI

Kimberly Carter Glick, OTR

  • Specialist
  • Visalia, CA
National Provider Identifier
1376615542
Registry record updated Mar 7, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
OT2176 Issued in CA
Practice address
1827 S Court St Ste C
Visalia, CA 93277-5469
Phone
(559) 738-8561
Fax
(559) 625-0389
NPI assigned
Nov 14, 2006
Last updated
Mar 7, 2008By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X OT2176 CA Primary

Addresses

Primary practice location

1827 S Court St Ste C
Visalia, CA 93277-5469

Mailing address

1827 S Court St Ste C
Visalia, CA 93277-5469
Phone (559) 738-8561

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070705000470 CA Practitioner - Occupational Therapist in Private Practice 7810096864 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Dash Therapy a Professional CorporationGroup PAC ID 3577733328, 3 clinicians

Practice addresses (Care Compare)

2208 W Sunnyside Ave
Suite a
Visalia, CA 93277-7292
Phone (559) 627-3274

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OT2176CAMDSpecialist
2176CAMDOccupational Therapy Assistant

Organizations & group practices 1

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": "1163462400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1204848000000",
    "number": "1376615542",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1827 S COURT ST STE C",
            "city": "VISALIA",
            "state": "CA",
            "postal_code": "932775469",
            "telephone_number": "559-738-8561",
            "fax_number": "559-625-0389"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1827 S COURT ST STE C",
            "city": "VISALIA",
            "state": "CA",
            "postal_code": "932775469",
            "telephone_number": "559-738-8561",
            "fax_number": "559-625-0389"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GLICK",
        "first_name": "KIMBERLY",
        "middle_name": "CARTER",
        "name_prefix": "Mrs.",
        "credential": "OTR",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-14",
        "last_updated": "2008-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "CA",
            "license": "OT2176",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Visalia, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2008; 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.