Jeanie Kim, OTR/L

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

OT25974 Issued in CA

Practice address

17042 Bellflower Blvd
Bellflower, CA 90706-5950

Phone

(562) 991-1324

Fax

(562) 502-9862

NPI assigned

Jan 31, 2024

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Specialty

Occupational Therapist in Private Practice

Education

Other, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Manale Rehabilitation Network IncGroup PAC ID 0749676138, 6 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Manale Rehabilitation Network Inc

  • Physical Rehabilitation Occupational Therapist
  • Bellflower, CA
  • NPI 1639827686
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1706659200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706659200000",
    "number": "1467215871",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "817 W BEVERLY BLVD STE 201",
            "city": "MONTEBELLO",
            "state": "CA",
            "postal_code": "906404265",
            "telephone_number": "562-927-5820"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17042 BELLFLOWER BLVD",
            "city": "BELLFLOWER",
            "state": "CA",
            "postal_code": "907065950",
            "telephone_number": "562-991-1324",
            "fax_number": "562-502-9862"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "JEANIE",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-01-31",
        "last_updated": "2024-01-31",
        "certification_date": "2024-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "CA",
            "license": "OT25974",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tiffany Khou, PHARMD
• Audrey Yong-Ah Kim, MD
• Dennis Kee Chul Kim, PHARM.D.
• Eddie S. Kim, MD
• Elaine Sangeun Kim, PHARM D
• Jinah Kim, PHARMACIST
• Joong Gap Kim, M.D.
• Kwang Ja Kim
• Mi Ok Kim, MSW
• Myoung Mee Kim, NP

• Occupational Therapist in Bellflower, CA
• Providers in Bellflower, CA by specialty
• Occupational Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2024; 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.