Individual provider Active NPI

Johanna Kalmus

  • Occupational Therapist
  • Shoreline, WA
National Provider Identifier
1700629482
Registry record updated Jul 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
OT61569805 Issued in WA
Practice address
2402 NW 195TH PL
Shoreline, WA 98177-2932
Phone
(206) 364-3777
Fax
(206) 364-3999
NPI assigned
Jun 18, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 11, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225X00000X OT61569805 WA Primary

Addresses

Primary practice location

2402 NW 195TH PL
Shoreline, WA 98177-2932

Mailing address

2402 NW 195TH PL
Shoreline, WA 98177-2932
Phone (206) 364-3777

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

LicenseStateTypeSpecialty
OT61569805WAMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Wonderland Developmental Center Multi-Specialty PastSince Jun 23, 2024 Accepting new patients
Wonderland Child & Family Services Multi-Specialty PastSince Jun 23, 2024 Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1718668800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720656000000",
    "number": "1700629482",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2402 NW 195TH PL",
            "city": "SHORELINE",
            "state": "WA",
            "postal_code": "981772932",
            "telephone_number": "206-364-3777",
            "fax_number": "206-364-3999"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2402 NW 195TH PL",
            "city": "SHORELINE",
            "state": "WA",
            "postal_code": "981772932",
            "telephone_number": "206-364-3777",
            "fax_number": "206-364-3999"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KALMUS",
        "first_name": "JOHANNA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-06-18",
        "last_updated": "2024-07-11",
        "certification_date": "2024-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapist",
            "state": "WA",
            "license": "OT61569805",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Shoreline, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.