Active NPI
Grace Kim
- Occupational Therapist
- Mechanicsburg, PA
National Provider Identifier
1629610910
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- OC015831
- Practice address
- 5225 Wilson LN
Mechanicsburg, PA 17055-6663 - Phone
- (717) 766-0279
- NPI assigned
- Oct 8, 2019
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | OC015831 | PA | Primary |
Addresses
Primary practice location
5225 Wilson LN
Mechanicsburg, PA 17055-6663
Mailing address
631 Gates LN
Enola, PA 17025-1610
Phone (717) 982-7665
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 |
|---|---|---|---|
| OC015831 | PA | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1570492800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1703548800000",
"number": "1629610910",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "631 GATES LN",
"city": "ENOLA",
"state": "PA",
"postal_code": "170251610",
"telephone_number": "717-982-7665"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5225 WILSON LN",
"city": "MECHANICSBURG",
"state": "PA",
"postal_code": "170556663",
"telephone_number": "717-766-0279"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KIM",
"first_name": "GRACE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2019-10-08",
"last_updated": "2023-12-26",
"certification_date": "2023-12-26",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "PA",
"license": "OC015831",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Mechanicsburg, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 26, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.