Individual provider Active NPI

Kimberly Huntington, OT

  • Occupational Therapist
  • West Grove, PA
National Provider Identifier
1396809299
Registry record updated Sep 12, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
04950 Issued in MD
Practice address
900 W Baltimore Pike Ste 103
West Grove, PA 19390-9313
Phone
(610) 869-2200
Fax
(610) 869-2311
NPI assigned
Dec 22, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 12, 2015

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 04950 MD Primary

Addresses

Primary practice location

900 W Baltimore Pike Ste 103
West Grove, PA 19390-9313

Mailing address

790 Remington Blvd
Bolingbrook, IL 60440-4909
Phone (630) 296-2223

Other names 1

  • Kimberly Lundahl Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20151022000646 PA Practitioner - Occupational Therapist in Private Practice 7810206422 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ati Holdings, LLCGroup PAC ID 9537112719, 440 clinicians

Practice addresses (Care Compare)

3483 E Lincoln Hwy
Unit 2
Thornsdale, PA 19372-1014
Phone (484) 784-4158

Merit-based Incentive Payment System (MIPS)

Final score
86.05 of 100Reported as group
Quality
89.12
Improvement activities
40
Cost
73.46

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
04950MDMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Ati Holdings, LLC Occupational Therapist CurrentSince Sep 3, 2015 Accepting new patients
Ati Holdings, LLC Occupational Therapist CurrentSince Sep 3, 2015 Accepting new patients

Locations

100 Valley Center Rd
Wilmington, DE 19808
Phone (302) 229-1986

790 Remington Blvd
Bolingbrook, IL 60440

4947 Paysphere Cir
Chicago, IL 60674
Phone (630) 783-2001

826 E Baltimore Pike
Unit 9
Kennett Square, PA 19348
Phone (610) 335-1410

9475 Roosevelt Blvd
Philadelphia, PA 19114
Phone (215) 464-6200

118 Townsedge Dr
Quarryville, PA 17566
Phone (717) 806-5126

3483 Lincoln Hwy
Unit 2
Thorndale, PA 19372
Phone (484) 784-4158

105 Vineyard Way
Ste 100
West Grove, PA 19390
Phone (610) 869-5792

900 W Baltimore Pike
Ste 103
West Grove, PA 19390
Phone (610) 709-6666

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": "1166745600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1442016000000",
    "number": "1396809299",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "790 REMINGTON BLVD",
            "city": "BOLINGBROOK",
            "state": "IL",
            "postal_code": "604404909",
            "telephone_number": "630-296-2223"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 W BALTIMORE PIKE STE 103",
            "city": "WEST GROVE",
            "state": "PA",
            "postal_code": "193909313",
            "telephone_number": "610-869-2200",
            "fax_number": "610-869-2311"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUNTINGTON",
        "first_name": "KIMBERLY",
        "credential": "OT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-22",
        "last_updated": "2015-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "MD",
            "license": "04950",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KIMBERLY",
            "last_name": "LUNDAHL",
            "credential": "OT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in West Grove, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2015; 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.