Individual provider Active NPI

Tami Leanne Brockschmidt, OTR/L

  • Occupational Therapist
  • Kent, WA
National Provider Identifier
1801147947
Registry record updated Sep 28, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
OT 00002772 Issued in WA
Practice address
22409 100TH Ave SE
Kent, WA 98031-4228
Phone
(253) 856-8053
NPI assigned
Sep 28, 2012
Last updated
Sep 28, 2012By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 28, 2012

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 OT 00002772 WA Primary

Addresses

Primary practice location

22409 100TH Ave SE
Kent, WA 98031-4228

Mailing address

22409 100TH Ave SE
Kent, WA 98031-4228
Phone (253) 856-8053

Other identifiers 1

IdentifierTypeStateIssuer
174400000XMedicaidWA

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
OT 00002772WAMDOccupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1348790400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1348790400000",
    "number": "1801147947",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22409 100TH AVE SE",
            "city": "KENT",
            "state": "WA",
            "postal_code": "980314228",
            "telephone_number": "253-856-8053"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22409 100TH AVE SE",
            "city": "KENT",
            "state": "WA",
            "postal_code": "980314228",
            "telephone_number": "253-856-8053"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROCKSCHMIDT",
        "first_name": "TAMI",
        "middle_name": "LEANNE",
        "name_prefix": "Mrs.",
        "credential": "OTR/L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-09-28",
        "last_updated": "2012-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "WA",
            "license": "OT 00002772",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "174400000X",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kent, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 2012; 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.