Individual provider Active NPI

Kristen Grim, MSOTR/L

  • Occupational Therapist
  • Boonsboro, MD
National Provider Identifier
1700343597
Registry record updated May 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
07989 Issued in MD
Practice address
8507 Mapleville Rd
Boonsboro, MD 21713-1818
Phone
(301) 733-6284
NPI assigned
Feb 27, 2019
Last updated
May 20, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 20, 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 07989 MD Primary

Addresses

Primary practice location

8507 Mapleville Rd
Boonsboro, MD 21713-1818

Mailing address

4974 Small Gains Way
Frederick, MD 21703-7352
Phone (240) 644-2331

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD, DC2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20240909004353 MD Practitioner - Occupational Therapist in Private Practice 5193265817 Reassigns benefits to 1 organization
I20240909004489 DC Practitioner - Occupational Therapist in Private Practice 5193265817 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Fox Rehab OT MD LLCGroup PAC ID 4981847977, 60 clinicians

Practice addresses (Care Compare)

11665 Doolittle Dr
Waldorf, MD 20602-2898
Phone (877) 407-3422

6451 N Charles St
Baltimore, MD 21212-1010
Phone (877) 407-3422

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Fox Rehab OT MD LLC Occupational Therapist CurrentSince Aug 1, 2024 Accepting new patients
Fox Rehabilitation Services LLC Occupational Therapist CurrentSince Aug 1, 2024 Accepting new patients

Locations

11665 Doolittle Dr
Waldorf, MD 20602
Phone (301) 638-4100

7 Carnegie Plz
Cherry Hill, NJ 08003

Organizations & group practices 2

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": "1551225600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716163200000",
    "number": "1700343597",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4974 SMALL GAINS WAY",
            "city": "FREDERICK",
            "state": "MD",
            "postal_code": "217037352",
            "telephone_number": "240-644-2331"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8507 MAPLEVILLE RD",
            "city": "BOONSBORO",
            "state": "MD",
            "postal_code": "217131818",
            "telephone_number": "301-733-6284"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRIM",
        "first_name": "KRISTEN",
        "credential": "MSOTR/L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-02-27",
        "last_updated": "2024-05-20",
        "certification_date": "2024-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "MD",
            "license": "07989",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boonsboro, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2024; 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.