Individual provider Active NPI

Juanita Hambright, OT

  • Occupational Therapist
  • Kennewick, WA
National Provider Identifier
1881137495
Registry record updated Aug 2, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
OT60457295 Issued in WA
Practice address
6699 W Rio Grande Ave
Kennewick, WA 99336-3301
Phone
(509) 460-5588
Fax
(509) 783-5438
NPI assigned
Nov 30, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 2, 2019

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 OT60457295 WA Primary

Addresses

Primary practice location

6699 W Rio Grande Ave
Kennewick, WA 99336-3301

Mailing address

6703 W Rio Grande Ave
Kennewick, WA 99336-2623
Phone (509) 460-5588

Other practice location 1

965 Goethals Dr
Richland, WA 99352-3527
Phone (509) 460-5588

Other identifiers 1

IdentifierTypeStateIssuer
2071645MedicaidWA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220519002238 ID Practitioner - Occupational Therapist in Private Practice 3173803814 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OT60457295WAMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
S.P.O.R.T. Physical Therapy Clinic CurrentSince Jun 1, 2022 Accepting new patients
S.P.O.R.T. Physical Therapy Clinic CurrentSince Jun 1, 2022 Accepting new patients

Locations

328 Warner Dr
Ste 8
Lewiston, ID 83501
Phone (208) 746-7573

3506 12th St
Lewiston, ID 83501
Phone (208) 746-0214

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": "1480464000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1564704000000",
    "number": "1881137495",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6703 W RIO GRANDE AVE",
            "city": "KENNEWICK",
            "state": "WA",
            "postal_code": "993362623",
            "telephone_number": "509-460-5588",
            "fax_number": "509-736-1503"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6699 W RIO GRANDE AVE",
            "city": "KENNEWICK",
            "state": "WA",
            "postal_code": "993363301",
            "telephone_number": "509-460-5588",
            "fax_number": "509-783-5438"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "965 Goethals Dr",
            "address_purpose": "LOCATION",
            "city": "Richland",
            "state": "WA",
            "postal_code": "993523527",
            "country_code": "US",
            "telephone_number": "509-460-5588",
            "fax_number": "509-736-1503",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HAMBRIGHT",
        "first_name": "JUANITA",
        "credential": "OT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-11-30",
        "last_updated": "2019-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "WA",
            "license": "OT60457295",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2071645",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kennewick, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 2019; 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.