Active NPI
Kristina Nicole McConnell, OT
- Occupational Therapist
- Olympia, WA
National Provider Identifier
1457647240
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- OT60976639
- Practice address
- 3901 Capital Mall Dr SW Ste D
Olympia, WA 98502-8654 - Phone
- (360) 709-6221
- Fax
- (360) 359-4727
- NPI assigned
- Jun 21, 2011
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | OT60976639 | WA | Primary |
Addresses
Primary practice location
3901 Capital Mall Dr SW Ste D
Olympia, WA 98502-8654
Mailing address
4631 Whitman LN SE Ste D
Lacey, WA 98513-2250
Phone (360) 338-0181
Other names 1
- Kristina Nicole Burks
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
Care Compare profile
Medicare Care CompareMerit-based Incentive Payment System (MIPS)
- Final score
- 79.72 of 100
- Quality
- 71.87
- Promoting interoperability
- 76
- Improvement activities
- 40
- Cost
- 80.52
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| OT60976639 | WA | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1308614400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1574640000000",
"number": "1457647240",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4631 WHITMAN LN SE STE D",
"city": "LACEY",
"state": "WA",
"postal_code": "985132250",
"telephone_number": "360-338-0181",
"fax_number": "360-338-0257"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3901 CAPITAL MALL DR SW STE D",
"city": "OLYMPIA",
"state": "WA",
"postal_code": "985028654",
"telephone_number": "360-709-6221",
"fax_number": "360-359-4727"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCCONNELL",
"first_name": "KRISTINA",
"middle_name": "NICOLE",
"credential": "OT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-06-21",
"last_updated": "2019-11-25",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "WA",
"license": "OT60976639",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "KRISTINA",
"last_name": "BURKS",
"middle_name": "NICOLE",
"code": "1",
"type": "Former Name"
}
]
}
Other providers in Olympia, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 25, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- 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.