Individual provider Active NPI

Donalyn Kay Germundson, OTRL

  • Occupational Therapist
  • Cherry Hill, NJ
National Provider Identifier
1578638292
Registry record updated Dec 9, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
105153-4201 Issued in UT
Practice address
7 Carnegie PLZ
Cherry Hill, NJ 08003-1000
Phone
(877) 407-3422
Fax
(877) 407-4329
NPI assigned
Nov 21, 2006
Last updated
Dec 9, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 9, 2022

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 105153-4201 UT Primary

Addresses

Primary practice location

7 Carnegie PLZ
Cherry Hill, NJ 08003-1000

Mailing address

1804 S Park St
Salt Lake City, UT 84105-2910
Phone (801) 484-7964

Other identifiers 1

IdentifierTypeStateIssuer
D3146MedicaidUT

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230309002799 WI Practitioner - Occupational Therapist in Private Practice 0840663951 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Fox Rehabilitation Services Wi LLCGroup PAC ID 1658647581, 144 clinicians

Practice addresses (Care Compare)

2130 Continental Dr
West Bend, WI 53095-7904
Phone (262) 338-0092

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
105153-4201UTMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Fox Rehabilitation Services Wi LLC Occupational Therapist CurrentSince Dec 1, 2022 Accepting new patients

Locations

7 Carnegie Plz
Cherry Hill, NJ 08003

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1164067200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1670544000000",
    "number": "1578638292",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1804 S PARK ST",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841052910",
            "telephone_number": "801-484-7964"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7 CARNEGIE PLZ",
            "city": "CHERRY HILL",
            "state": "NJ",
            "postal_code": "080031000",
            "telephone_number": "877-407-3422",
            "fax_number": "877-407-4329"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GERMUNDSON",
        "first_name": "DONALYN",
        "middle_name": "KAY",
        "name_prefix": "Mrs.",
        "credential": "OTRL",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-21",
        "last_updated": "2022-12-09",
        "certification_date": "2022-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "UT",
            "license": "105153-4201",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "D3146",
            "state": "UT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cherry Hill, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2022; 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.