Individual provider Active NPI

Kylee Michelle Permann, OTD, OTR/L

  • Hand Occupational Therapist
  • Pocatello, ID
National Provider Identifier
1003279357
Registry record updated Apr 4, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hand Occupational TherapistTaxonomy code 225XH1200X
License
1559 Issued in ID
Practice address
560 Memorial Dr Ste B
Pocatello, ID 83201-4073
Phone
(208) 478-0258
Fax
(208) 269-7336
NPI assigned
Apr 4, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 4, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hand Occupational Therapist 225XH1200X 1559 ID Primary

Addresses

Primary practice location

560 Memorial Dr Ste B
Pocatello, ID 83201-4073

Mailing address

560 Memorial Dr Ste B
Pocatello, ID 83201-4073
Phone (208) 478-0258

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
1559IDMDHand Occupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Kokua Rehabilitation Hand PastSince Sep 8, 2019 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.

NPI Registry JSON

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

{
    "created_epoch": "1459728000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1459728000000",
    "number": "1003279357",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "560 MEMORIAL DR STE B",
            "city": "POCATELLO",
            "state": "ID",
            "postal_code": "832014073",
            "telephone_number": "208-478-0258",
            "fax_number": "208-269-7336"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "560 MEMORIAL DR STE B",
            "city": "POCATELLO",
            "state": "ID",
            "postal_code": "832014073",
            "telephone_number": "208-478-0258",
            "fax_number": "208-269-7336"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PERMANN",
        "first_name": "KYLEE",
        "middle_name": "MICHELLE",
        "credential": "OTD, OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-04-04",
        "last_updated": "2016-04-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XH1200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Hand",
            "state": "ID",
            "license": "1559",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pocatello, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 4, 2016; 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.