NPIMap

Individual provider Active NPI

Karen Baird-Knickerbocker, OT

  • Occupational Therapist
  • Socorro, NM
National Provider Identifier
1992739403
Registry record updated Apr 28, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
2067 Issued in NM
Practice address
911 N California Street
Suite B
Socorro, NM 87801
Phone
(505) 838-1000
Fax
(505) 838-2000
NPI assigned
Jul 10, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 28, 2010

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 2067 NM Primary

Addresses

Primary practice location

911 N California Street
Suite B
Socorro, NM 87801

Mailing address

911 N California Street
Suite B
Socorro, NM 87801
Phone (575) 838-1000

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
2067NMMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Meier & Marsh Professional PastSince Feb 1, 2015 Accepting new patients
Socorro Physical Therapy Incorporated Occupational Therapist PastSince Apr 1, 2010 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1152489600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1272412800000",
    "number": "1992739403",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "911 N CALIFORNIA STREET",
            "address_2": "SUITE B",
            "city": "SOCORRO",
            "state": "NM",
            "postal_code": "87801",
            "telephone_number": "575-838-1000",
            "fax_number": "575-838-2000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "911 N CALIFORNIA STREET",
            "address_2": "SUITE B",
            "city": "SOCORRO",
            "state": "NM",
            "postal_code": "87801",
            "telephone_number": "505-838-1000",
            "fax_number": "505-838-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAIRD-KNICKERBOCKER",
        "first_name": "KAREN",
        "name_prefix": "Mrs.",
        "credential": "OT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-10",
        "last_updated": "2010-04-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NM",
            "license": "2067",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Socorro, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 2010; 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.