Individual provider Active NPI

Judith Marie Emmanere, OTR/L, CHT

  • Hand Occupational Therapist
  • Eugene, OR
National Provider Identifier
1750693552
Registry record updated Jan 24, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hand Occupational TherapistTaxonomy code 225XH1200X
License
428300 Issued in OR
Practice address
1800 Coburg Rd
Eugene, OR 97401-4995
Phone
(541) 640-7625
NPI assigned
Jul 8, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 24, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hand Occupational Therapist 225XH1200X 428300 OR Primary

Addresses

Primary practice location

1800 Coburg Rd
Eugene, OR 97401-4995

Mailing address

1292 High St Ste 224
Eugene, OR 97401-3238
Phone (541) 500-2500

Other practice location 1

598 E 13th Ave
Eugene, OR 97401-4783
Phone (541) 640-7625

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110502000745 OR Practitioner - Occupational Therapist in Private Practice 2163607482 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Willamette Community Health Solutions CurrentSince Feb 1, 2022 Accepting new patients
Icco LLC CurrentSince Oct 1, 2010 Accepting new patients
Willamette Community Health Solutions CurrentSince Feb 1, 2022 Accepting new patients
Icco, LLC CurrentSince Oct 1, 2010 Accepting new patients
Willamette Community Health Solutions Past Accepting new patients

Locations

89 Centennial Loop
Ste A
Eugene, OR 97401
Phone (541) 228-3000

598 E 13th Ave
Eugene, OR 97401
Phone (541) 636-3473

1292 High St
Eugene, OR 97401
Phone (541) 636-3473

2650 Suzanne Way
Ste 200
Eugene, OR 97408
Phone (541) 228-3000

1800 Coburg Rd
Eugene, OR 97401
Phone (541) 342-1632

Organizations & group practices 5

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": "1278547200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1579824000000",
    "number": "1750693552",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1292 HIGH ST STE 224",
            "city": "EUGENE",
            "state": "OR",
            "postal_code": "974013238",
            "telephone_number": "541-500-2500",
            "fax_number": "541-636-3480"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1800 COBURG RD",
            "city": "EUGENE",
            "state": "OR",
            "postal_code": "974014995",
            "telephone_number": "541-640-7625"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "598 E 13th Ave",
            "address_purpose": "LOCATION",
            "city": "Eugene",
            "state": "OR",
            "postal_code": "974014783",
            "country_code": "US",
            "telephone_number": "541-640-7625",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "EMMANERE",
        "first_name": "JUDITH",
        "middle_name": "MARIE",
        "name_prefix": "Ms.",
        "credential": "OTR/L, CHT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-07-08",
        "last_updated": "2020-01-24",
        "certification_date": "2020-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XH1200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Hand",
            "state": "OR",
            "license": "428300",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Eugene, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2020; 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.