Individual provider Active NPI

Kaila Amri Mangrum, OTD, OTR/L

  • Occupational Therapist
  • Las Vegas, NV
National Provider Identifier
1033082508
Registry record updated Sep 29, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
OT-3769 Issued in NV
Practice address
1225 Triumph CT
Las Vegas, NV 89117-7122
Phone
(702) 350-2652
Fax
(775) 571-8976
NPI assigned
Sep 29, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 29, 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 OT-3769 NV Primary

Addresses

Primary practice location

1225 Triumph CT
Las Vegas, NV 89117-7122

Mailing address

1225 Triumph CT
Las Vegas, NV 89117-7122
Phone (702) 350-2652

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
OT-3769NVMDOccupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1759104000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1759104000000",
    "number": "1033082508",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1225 TRIUMPH CT",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891177122",
            "telephone_number": "702-350-2652",
            "fax_number": "775-571-8976"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1225 TRIUMPH CT",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891177122",
            "telephone_number": "702-350-2652",
            "fax_number": "775-571-8976"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANGRUM",
        "first_name": "KAILA",
        "middle_name": "AMRI",
        "name_prefix": "Dr.",
        "credential": "OTD, OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-09-29",
        "last_updated": "2025-09-29",
        "certification_date": "2025-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NV",
            "license": "OT-3769",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2025; 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.