Individual provider Active NPI

Kristen Romm, MOT

  • Occupational Therapist
  • Rexburg, ID
National Provider Identifier
1649006701
Registry record updated Sep 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
954135 Issued in ID
Practice address
36 Professional PLZ Ste 110
Rexburg, ID 83440-2049
Phone
(208) 359-9570
Fax
(208) 359-9580
NPI assigned
Sep 13, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 13, 2024

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 954135 ID Primary

Addresses

Primary practice location

36 Professional PLZ Ste 110
Rexburg, ID 83440-2049

Mailing address

36 Professional PLZ Ste 110
Rexburg, ID 83440-2049
Phone (208) 359-9570

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241022002124 ID Practitioner - Occupational Therapist in Private Practice 2365974805 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
954135IDMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
MHD Therapies, PLLC Occupational Therapist CurrentSince Sep 18, 2024 Accepting new patients

Locations

36 Professional Plz
Ste 110
Rexburg, ID 83440
Phone (208) 359-9570

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1726185600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726185600000",
    "number": "1649006701",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "36 PROFESSIONAL PLZ STE 110",
            "city": "REXBURG",
            "state": "ID",
            "postal_code": "834402049",
            "telephone_number": "208-359-9570",
            "fax_number": "208-359-9580"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "36 PROFESSIONAL PLZ STE 110",
            "city": "REXBURG",
            "state": "ID",
            "postal_code": "834402049",
            "telephone_number": "208-359-9570",
            "fax_number": "208-359-9580"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROMM",
        "first_name": "KRISTEN",
        "credential": "MOT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-09-13",
        "last_updated": "2024-09-13",
        "certification_date": "2024-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "ID",
            "license": "954135",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rexburg, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.