Jamae' Kmak, MS OTR/L

Primary specialty

Early Intervention Provider AgencyTaxonomy code 252Y00000X

License

5945 Issued in AZ

Practice address

17300 N 88TH Ave
Peoria, AZ 85382-3501

Phone

(602) 290-4880

NPI assigned

Sep 21, 2014

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Jamae' Van Eeuwen Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

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

{
    "created_epoch": "1411257600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713916800000",
    "number": "1558763532",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "140 E CORAL GABLES DR",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850223690",
            "telephone_number": "602-290-4880"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17300 N 88TH AVE",
            "city": "PEORIA",
            "state": "AZ",
            "postal_code": "853823501",
            "telephone_number": "602-290-4880"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4045 E Union Hills Dr Ste 110",
            "address_purpose": "LOCATION",
            "city": "Phoenix",
            "state": "AZ",
            "postal_code": "850503389",
            "country_code": "US",
            "telephone_number": "602-595-0074",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KMAK",
        "first_name": "JAMAE'",
        "credential": "MS OTR/L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-09-21",
        "last_updated": "2024-04-24",
        "certification_date": "2024-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "252Y00000X",
            "taxonomy_group": "",
            "desc": "Early Intervention Provider Agency",
            "state": "AZ",
            "license": "5945",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JAMAE'",
            "last_name": "VAN EEUWEN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Erik Klinker, PHARM.D.
• Fredric H Klopf, MD
• Jacob Kloser
• Tammy Kloser
• Drew Klug, M.D.
• Michaela Kniesova, MD
• Toure Ali Knighton, MD
• Knowledge Tutoring Services
• Julie Ann Knowles, RN
• Rachel E Knudson, LPC

• Early Intervention Provider Agency in Peoria, AZ
• Providers in Peoria, AZ by specialty
• Early Intervention Provider Agency in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2024; 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.