NPIMap

Individual provider Active NPI

Jaime Lynn King, OTR/L

  • Occupational Therapist
  • Grand Coulee, WA
National Provider Identifier
1932309846
Registry record updated Jul 23, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
OT00003607 Issued in WA
Practice address
321 Burdin Boulevard
Grand Coulee, WA 99133-0680
Phone
(509) 633-3260
Fax
(509) 633-3212
NPI assigned
Jul 19, 2007
Last updated
Jul 23, 2007By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 23, 2007

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 OT00003607 WA Primary

Addresses

Primary practice location

321 Burdin Boulevard
Grand Coulee, WA 99133-0680

Mailing address

PO Box 680
321 Burdin Blvd.
Grand Coulee, WA 99133-0680
Phone (509) 633-3260

Other identifiers 2

IdentifierTypeStateIssuer
8404279MedicaidWA
8802757OtherWAMEDICARE GROUP PIN

Other names 1

  • Jaime Lynn Benner Former name

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
OT00003607WAMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Douglas, Grant, Lincoln & Okanogan Counties Public Hospital District 6 Past Accepting new patients
Richard M King Past Accepting new patients

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1184803200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1185148800000",
    "number": "1932309846",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 680",
            "address_2": "321 BURDIN BLVD.",
            "city": "GRAND COULEE",
            "state": "WA",
            "postal_code": "991330680",
            "telephone_number": "509-633-3260",
            "fax_number": "509-633-3212"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "321 BURDIN BOULEVARD",
            "city": "GRAND COULEE",
            "state": "WA",
            "postal_code": "991330680",
            "telephone_number": "509-633-3260",
            "fax_number": "509-633-3212"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KING",
        "first_name": "JAIME",
        "middle_name": "LYNN",
        "name_prefix": "Mrs.",
        "credential": "OTR/L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-07-19",
        "last_updated": "2007-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "WA",
            "license": "OT00003607",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8404279",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP PIN",
            "identifier": "8802757",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JAIME",
            "last_name": "BENNER",
            "middle_name": "LYNN",
            "credential": "OTR/L",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Grand Coulee, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2007; 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.