Individual provider Active NPI

Kathryn Grace Taylor, OTD, OTR/L

  • Occupational Therapist
  • Fort Mill, SC
National Provider Identifier
1003705534
Registry record updated Jun 30, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
7645 Issued in SC
Practice address
130 Crisanto Ave Ste a
Fort Mill, SC 29715-6272
Phone
(803) 487-5638
NPI assigned
Jun 30, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 30, 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 7645 SC Primary

Addresses

Primary practice location

130 Crisanto Ave Ste a
Fort Mill, SC 29715-6272

Mailing address

130 Crisanto Ave Ste a
Fort Mill, SC 29715-6272
Phone (803) 746-4655

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250722001319 SC Practitioner - Occupational Therapist in Private Practice 8224544796 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ivyrehab Focus, Inc.Group PAC ID 5890851406, 39 clinicians

Practice addresses (Care Compare)

130 Crisanto Ave
Suite a
Fort Mill, SC 29715-6272
Phone (803) 746-4655

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Ivyrehab Focus, Inc. CurrentSince Jul 8, 2025 Accepting new patients
Ivyrehab Focus, Inc. CurrentSince Jul 8, 2025 Accepting new patients

Locations

130 Crisanto Ave
Ste A
Fort Mill, SC 29715
Phone (803) 487-5638

439 Channel Rd
Ste 102
Lake Wylie, SC 29710
Phone (619) 977-0480

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": "1751241600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1751241600000",
    "number": "1003705534",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "130 CRISANTO AVE STE A",
            "city": "FORT MILL",
            "state": "SC",
            "postal_code": "297156272",
            "telephone_number": "803-746-4655"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "130 CRISANTO AVE STE A",
            "city": "FORT MILL",
            "state": "SC",
            "postal_code": "297156272",
            "telephone_number": "803-487-5638"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAYLOR",
        "first_name": "KATHRYN",
        "middle_name": "GRACE",
        "name_prefix": "Dr.",
        "credential": "OTD, OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-06-30",
        "last_updated": "2025-06-30",
        "certification_date": "2025-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "SC",
            "license": "7645",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Mill, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2025; 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.