Active NPI
Kristen Gunderson, OTR
- Occupational Therapist
- Orlando, FL
National Provider Identifier
1619429628
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- OT 18067
- Practice address
- 3016 Amherst Ave
Orlando, FL 32804-3854 - Phone
- (281) 299-7505
- NPI assigned
- Oct 26, 2016
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 106488 | TX | |
| Occupational Therapist | 225X00000X | OT 18067 | FL | Primary |
Addresses
Primary practice location
3016 Amherst Ave
Orlando, FL 32804-3854
Mailing address
3016 Amherst Ave
Orlando, FL 32804-3854
Phone (281) 299-7505
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| OT 18067 | FL | MD | Occupational Therapist |
| 106488 | TX | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1477440000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1562716800000",
"number": "1619429628",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3016 AMHERST AVE",
"city": "ORLANDO",
"state": "FL",
"postal_code": "328043854",
"telephone_number": "281-299-7505"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3016 AMHERST AVE",
"city": "ORLANDO",
"state": "FL",
"postal_code": "328043854",
"telephone_number": "281-299-7505"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GUNDERSON",
"first_name": "KRISTEN",
"credential": "OTR",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2016-10-26",
"last_updated": "2019-07-10",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "TX",
"license": "106488",
"primary": false
},
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "FL",
"license": "OT 18067",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Orlando, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.