Individual provider Active NPI

Kimberly A Christensen, OTR/L

  • Occupational Therapist
  • Moline, IL
National Provider Identifier
1972544906
Registry record updated Jun 23, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
056-006910 Issued in IL
Practice address
510 Valley View Dr
Moline, IL 61265-6133
Phone
(309) 797-0866
NPI assigned
Jun 9, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 23, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X IA
Occupational Therapist 225X00000X 056-006910 IL Primary

Addresses

Primary practice location

510 Valley View Dr
Moline, IL 61265-6133

Mailing address

850 43Rd Ave Ste 100
Moline, IL 61265-8401
Phone (309) 743-2070

Other practice location 1

6101 Northwest Blvd
Davenport, IA 52806-1861
Phone (563) 449-7004

Other identifiers 1

IdentifierTypeStateIssuer
056-006910OtherILILLINOIS PT LICENSE NUMBE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL, IA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20070315000380 IL Practitioner - Occupational Therapist in Private Practice 0648373431 Reassigns benefits to 2 organizations
I20091105000286 IA Practitioner - Occupational Therapist in Private Practice 0648373431 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Rock Valley Physical Therapy Center 232 clinicians

Practice addresses (Care Compare)

4451 E 53Rd St
Suite 200
Davenport, IA 52807-3142
Phone (563) 362-0016

850 43Rd Ave
Suite 100
Moline, IL 61265-8401

902 Illini Dr
Silvis, IL 61282-4700
Phone (309) 796-3450

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
056-006910ILMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Rock Valley Physical Therapy Center Occupational Therapist CurrentSince Apr 1, 2007 Accepting new patients
Rock Valley Physical Therapy Center Occupational Therapist CurrentSince Apr 1, 2007 Accepting new patients
Ora Orthopedics, PC Past Accepting new patients

Locations

3385 Dexter Ct
Ste 203
Davenport, IA 52807
Phone (563) 332-9312

850 43rd Ave
Ste 200
Moline, IL 61265
Phone (309) 743-0300

520 Valley View Dr
Moline, IL 61265
Phone (309) 762-1952

850 43rd Ave
Ste 300
Moline, IL 61265
Phone (309) 743-0300

850 43rd Ave
Ste 100
Moline, IL 61265
Phone (309) 743-2070

902 Illini Dr
Silvis, IL 61282
Phone (309) 796-3450

Organizations & group practices 7

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": "1149811200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624406400000",
    "number": "1972544906",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "850 43RD AVE STE 100",
            "city": "MOLINE",
            "state": "IL",
            "postal_code": "612658401",
            "telephone_number": "309-743-2070",
            "fax_number": "309-743-2073"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "510 VALLEY VIEW DR",
            "city": "MOLINE",
            "state": "IL",
            "postal_code": "612656133",
            "telephone_number": "309-797-0866"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6101 Northwest Blvd",
            "address_purpose": "LOCATION",
            "city": "Davenport",
            "state": "IA",
            "postal_code": "528061861",
            "country_code": "US",
            "telephone_number": "563-449-7004",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHRISTENSEN",
        "first_name": "KIMBERLY",
        "middle_name": "A",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-09",
        "last_updated": "2021-06-23",
        "certification_date": "2021-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "IA",
            "license": null,
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "IL",
            "license": "056-006910",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ILLINOIS PT LICENSE NUMBE",
            "identifier": "056-006910",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Moline, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.