NPIMap

Organization Active NPI

Kimberly J Evans Otr L CHT Professional Corporation

  • Hand Occupational Therapist
  • Orange, CA
National Provider Identifier
1871022756
Registry record updated Jun 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hand Occupational TherapistTaxonomy code 225XH1200X
License
11316 Issued in CA
Legal business name
KIMBERLY J EVANS OTR L CHT PROFESSIONAL CORPORATION
Practice address
1740 W Katella Ave Ste D
Orange, CA 92867-3434
Phone
(714) 831-5599
Fax
(714) 783-3318
NPI assigned
Jun 5, 2017
Last updated
Jun 5, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 5, 2024

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

Authorized official

Name
Kimberly J Evans, M.S. OTNPI 1346541679
Title
Otr/L, CHT
Phone
(951) 764-4489

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hand Occupational TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225XH1200X 11316 CA Primary

Addresses

Primary practice location

1740 W Katella Ave Ste D
Orange, CA 92867-3434

Mailing address

817 S Anaheim Blvd Unit 103
Anaheim, CA 92805-5295

Other practice location 1

817 S Anaheim Blvd Unit 103
Anaheim, CA 92805-5295
Phone (951) 764-4489

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20170710000105 CA Part B Supplier - Clinic/Group Practice 4183993066 Receives reassigned benefits from 4 practitioners
1 other NPI on this enrollment
Practice locations: Orange, CA; Temecula, CA
O20170918002238 CA DME Supplier - Independently-Practicing Occupational Therapist 4183993066 Practice locations: Orange, CA

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Kimberly J Evans Otr L CHT Professional Corporation2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Ownership & related parties

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1496620800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1717545600000",
    "number": "1871022756",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "817 S ANAHEIM BLVD UNIT 103",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928055295"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1740 W KATELLA AVE STE D",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928673434",
            "telephone_number": "714-831-5599",
            "fax_number": "714-783-3318"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "817 S Anaheim Blvd Unit 103",
            "address_purpose": "LOCATION",
            "city": "Anaheim",
            "state": "CA",
            "postal_code": "928055295",
            "country_code": "US",
            "telephone_number": "951-764-4489",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "KIMBERLY J EVANS OTR L CHT PROFESSIONAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-06-05",
        "last_updated": "2024-06-05",
        "certification_date": "2024-06-05",
        "status": "A",
        "authorized_official_last_name": "EVANS",
        "authorized_official_first_name": "KIMBERLY",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OTR/L, CHT",
        "authorized_official_telephone_number": "951-764-4489",
        "authorized_official_credential": "M.S. OT"
    },
    "taxonomies": [
        {
            "code": "225XH1200X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Occupational Therapist, Hand",
            "state": "CA",
            "license": "11316",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orange, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2024; 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.