Karly Mitchell Slade, COTA/L

Primary specialty

Occupational Therapy AssistantTaxonomy code 224Z00000X

License

TA3243 Issued in MS

Practice address

311 N Main St
Picayune, MS 39466-3313

Phone

(601) 799-4065

Fax

(601) 620-4117

NPI assigned

Sep 26, 2016

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1474848000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1474848000000",
    "number": "1043769458",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "75 DUPONT HARTS CHAPEL RD",
            "city": "POPLARVILLE",
            "state": "MS",
            "postal_code": "394704014",
            "telephone_number": "601-463-0993"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "311 N MAIN ST",
            "city": "PICAYUNE",
            "state": "MS",
            "postal_code": "394663313",
            "telephone_number": "601-799-4065",
            "fax_number": "601-620-4117"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SLADE",
        "first_name": "KARLY",
        "middle_name": "MITCHELL",
        "name_prefix": "Mrs.",
        "credential": "COTA/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-09-26",
        "last_updated": "2016-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "MS",
            "license": "TA3243",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kendal Blaine Silve, PHARM D
• Silver Medical Associates, LLC
• Rhonda Simmons, LCSW
• Elizabeth Ann Skipper, LCSW
• Daniel Zane Slade
• Shannon Elaine Slizoski, LMFT
• Antonio D Smith
• Holly R Smith, LCSW
• Lisa A Smith, LPC
• Penelope Smith, LMT

• Occupational Therapy Assistant in Picayune, MS
• Providers in Picayune, MS by specialty
• Occupational Therapy Assistant in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 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.