Individual provider Active NPI

Kristina Nicole McConnell, OT

  • Occupational Therapist
  • Olympia, WA
National Provider Identifier
1457647240
Registry record updated Nov 25, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
OT60976639 Issued in WA
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

Updated by the provider on Nov 25, 2019

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 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 Former name

Medicare participation

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

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
79.72 of 100Reported as group
Quality
71.87
Promoting interoperability
76
Improvement activities
40
Cost
80.52

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OT60976639WAMDOccupational 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.

Verify at the official NPI Registry.