Active NPI
Emily Ruth Kidney, OTD
- Occupational Therapist
- Beaverton, OR
National Provider Identifier
1962006114
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 414409
- Practice address
- 8625 SW Cascade Ave Ste 320
Beaverton, OR 97008-7126 - Phone
- (877) 755-8940
- NPI assigned
- Nov 29, 2020
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 414409 | OR | Primary |
Addresses
Primary practice location
8625 SW Cascade Ave Ste 320
Beaverton, OR 97008-7126
Mailing address
574 N Lombard St
Portland, OR 97217-1574
Phone (937) 269-5470
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
| License | State | Type | Specialty |
|---|---|---|---|
| 414409 | OR | MD | Occupational Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Kidscare Home Health of Oregon LLC | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Home Health Agency
- Beaverton, OR
- NPI 1205446135
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1606608000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1606608000000",
"number": "1962006114",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "574 N LOMBARD ST",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972171574",
"telephone_number": "937-269-5470"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8625 SW CASCADE AVE STE 320",
"city": "BEAVERTON",
"state": "OR",
"postal_code": "970087126",
"telephone_number": "877-755-8940"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KIDNEY",
"first_name": "EMILY",
"middle_name": "RUTH",
"name_prefix": "Dr.",
"credential": "OTD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2020-11-29",
"last_updated": "2020-11-29",
"certification_date": "2020-11-29",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Occupational Therapist",
"state": "OR",
"license": "414409",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Beaverton, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.