Individual provider Active NPI

Kymberlee Ann Boston, OTD OTR/L

  • Occupational Therapist
  • Bozeman, MT
National Provider Identifier
1992514202
Registry record updated Jan 1, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
OTP-OT-LIC-10501 Issued in MT
Practice address
612 W Griffin Dr Ste a
Bozeman, MT 59715-2578
Phone
(406) 298-3851
Fax
(406) 578-1443
NPI assigned
Jan 1, 2025
Last updated
Jan 1, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 1, 2025

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 OTP-OT-LIC-10501 MT Primary

Addresses

Primary practice location

612 W Griffin Dr Ste a
Bozeman, MT 59715-2578

Mailing address

612 W Griffin Dr Ste a
Bozeman, MT 59715-2578
Phone (406) 298-3851

Other practice location 1

2411 W Main St Ste 2
Bozeman, MT 59718-3815
Phone (406) 298-3851

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250210002131 MT Practitioner - Occupational Therapist in Private Practice 6406386242 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Root Therapy and Wellness Occupational Therapist CurrentSince Jan 13, 2025 Accepting new patients
Spinerx Scoliosis and Spine Rehab, LLC PastSince Jan 13, 2025 Accepting new patients

Locations

2411 W Main St
Ste 2
Bozeman, MT 59718
Phone (406) 219-5388

612 W Griffin Dr
Ste A
Bozeman, MT 59715
Phone (406) 219-5388

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": "1735689600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1735689600000",
    "number": "1992514202",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "612 W GRIFFIN DR STE A",
            "city": "BOZEMAN",
            "state": "MT",
            "postal_code": "597152578",
            "telephone_number": "406-298-3851",
            "fax_number": "406-578-1443"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "612 W GRIFFIN DR STE A",
            "city": "BOZEMAN",
            "state": "MT",
            "postal_code": "597152578",
            "telephone_number": "406-298-3851",
            "fax_number": "406-578-1443"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2411 W Main St Ste 2",
            "address_purpose": "LOCATION",
            "city": "Bozeman",
            "state": "MT",
            "postal_code": "597183815",
            "country_code": "US",
            "telephone_number": "406-298-3851",
            "fax_number": "406-578-1443",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BOSTON",
        "first_name": "KYMBERLEE",
        "middle_name": "ANN",
        "credential": "OTD OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-01-01",
        "last_updated": "2025-01-01",
        "certification_date": "2025-01-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "MT",
            "license": "OTP-OT-LIC-10501",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bozeman, MT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 1, 2025; 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.