Individual provider Active NPI

Kimberly Shawn O'Grady, OTR/L

  • Neurorehabilitation Occupational Therapist
  • Eugene, OR
National Provider Identifier
1417119967
Registry record updated Jun 26, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurorehabilitation Occupational TherapistTaxonomy code 225XN1300X
License
914163 Issued in OR
Practice address
2195 W 28TH Ave
Eugene, OR 97405-1798
Phone
(541) 653-8084
NPI assigned
Jun 26, 2008
Last updated
Jun 26, 2008By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 26, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurorehabilitation Occupational Therapist 225XN1300X 914163 OR Primary

Addresses

Primary practice location

2195 W 28TH Ave
Eugene, OR 97405-1798

Mailing address

2195 W 28TH Ave
Eugene, OR 97405-1798
Phone (541) 653-8084

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
914163ORMDNeurorehabilitation Occupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1214438400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1214438400000",
    "number": "1417119967",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2195 W 28TH AVE",
            "city": "EUGENE",
            "state": "OR",
            "postal_code": "974051798",
            "telephone_number": "541-653-8084"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2195 W 28TH AVE",
            "city": "EUGENE",
            "state": "OR",
            "postal_code": "974051798",
            "telephone_number": "541-653-8084"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "O'GRADY",
        "first_name": "KIMBERLY",
        "middle_name": "SHAWN",
        "name_prefix": "Mrs.",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-06-26",
        "last_updated": "2008-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XN1300X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Neurorehabilitation",
            "state": "OR",
            "license": "914163",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Eugene, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.