Individual provider Active NPI

Charmaine Lim, OT

  • Occupational Therapist
  • Ontario, CA
National Provider Identifier
1447843214
Registry record updated Feb 17, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
21259 Issued in CA
Practice address
1950 S Mountain Ave
Ontario, CA 91762-6723
Phone
(909) 983-0084
NPI assigned
Feb 12, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 17, 2021

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 21259 CA Primary

Addresses

Primary practice location

1950 S Mountain Ave
Ontario, CA 91762-6723

Mailing address

8200 Haven Ave Apt 11204
Rancho Cucamonga, CA 91730-6982

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL Ontario

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231024003227 CA Practitioner - Occupational Therapist in Private Practice 0840646030 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
21259CAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Sand Coast Rehab Physical Therapy Inc Occupational Therapist CurrentSince Sep 11, 2023 Accepting new patients

Locations

441 E Carson St
Ste K
Carson, CA 90745
Phone (732) 375-0420

625 Mayflower Rd
Claremont, CA 91711

650 Harrison Ave
Claremont, CA 91711
Phone (888) 627-2900

3558 Round Barn Blvd
Ste 600
Santa Rosa, CA 95403

400 Route 70
Lakewood, NJ 08701
Phone (732) 802-7512

Interoperability endpoints

  • Direct secure messaging: charmaine.lim.p1@direct.evchc.nextgenshare.com

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1613088000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1613520000000",
    "number": "1447843214",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8200 HAVEN AVE APT 11204",
            "city": "RANCHO CUCAMONGA",
            "state": "CA",
            "postal_code": "917306982"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1950 S MOUNTAIN AVE",
            "city": "ONTARIO",
            "state": "CA",
            "postal_code": "917626723",
            "telephone_number": "909-983-0084"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIM",
        "first_name": "CHARMAINE",
        "name_prefix": "Ms.",
        "credential": "OT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-02-12",
        "last_updated": "2021-02-17",
        "certification_date": "2021-02-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "CA",
            "license": "21259",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Ontario",
            "affiliation": "N",
            "address_1": "1950 S Mountain Ave",
            "city": "Ontario",
            "state": "CA",
            "country_code": "US",
            "postal_code": "917626723",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Ontario, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 2021; 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.