Individual provider Active NPI

Emily Kwan, OT

  • Occupational Therapist
  • Fountain Hills, AZ
National Provider Identifier
1861188286
Registry record updated Sep 27, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
OTH-009633 Issued in AZ
Practice address
17100 E Shea Blvd Ste 600
Fountain Hills, AZ 85268-6663
Phone
(702) 360-1137
NPI assigned
Apr 18, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 27, 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 OTH-009633 AZ Primary

Addresses

Primary practice location

17100 E Shea Blvd Ste 600
Fountain Hills, AZ 85268-6663

Mailing address

9150 W Indian School Rd Ste 130
Phoenix, AZ 85037-2388
Phone (480) 787-5387

Other practice location 1

16844 N 59th Ave
Glendale, AZ 85306-1118
Phone (480) 787-5387

Other identifiers 1

IdentifierTypeStateIssuer
206722MedicaidAZ

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
OTH-009633AZMDOccupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1681776000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727395200000",
    "number": "1861188286",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9150 W INDIAN SCHOOL RD STE 130",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850372388",
            "telephone_number": "480-787-5387",
            "fax_number": "623-232-3250"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17100 E SHEA BLVD STE 600",
            "city": "FOUNTAIN HILLS",
            "state": "AZ",
            "postal_code": "852686663",
            "telephone_number": "702-360-1137"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "16844 N 59th Ave",
            "address_purpose": "LOCATION",
            "city": "Glendale",
            "state": "AZ",
            "postal_code": "853061118",
            "country_code": "US",
            "telephone_number": "480-787-5387",
            "fax_number": "623-209-8822",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KWAN",
        "first_name": "EMILY",
        "credential": "OT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-04-18",
        "last_updated": "2024-09-27",
        "certification_date": "2024-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "AZ",
            "license": "OTH-009633",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "206722",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fountain Hills, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 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.