Individual provider Active NPI

Kyleigh Alexis Bernath, COTA/L

  • Occupational Therapy Assistant
  • Tarpon Springs, FL
National Provider Identifier
1053038000
Registry record updated Apr 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Therapy AssistantTaxonomy code 224Z00000X
License
OTA19370 Issued in FL
Practice address
515 Chesapeake Dr
Tarpon Springs, FL 34689-2515
Phone
(727) 938-6513
NPI assigned
Oct 20, 2022
Last updated
Apr 3, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 3, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy Assistant 224Z00000X OTA008325 OH
Occupational Therapy Assistant 224Z00000X OTA19370 FL Primary

Addresses

Primary practice location

515 Chesapeake Dr
Tarpon Springs, FL 34689-2515

Mailing address

2621 W Grand Reserve Cir Apt 425
Clearwater, FL 33759-3975

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
OTA19370FLMDOccupational Therapy Assistant
OTA008325OHMDOccupational Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1666224000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1680480000000",
    "number": "1053038000",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2621 W GRAND RESERVE CIR APT 425",
            "city": "CLEARWATER",
            "state": "FL",
            "postal_code": "337593975"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "515 CHESAPEAKE DR",
            "city": "TARPON SPRINGS",
            "state": "FL",
            "postal_code": "346892515",
            "telephone_number": "727-938-6513"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERNATH",
        "first_name": "KYLEIGH",
        "middle_name": "ALEXIS",
        "credential": "COTA/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-10-20",
        "last_updated": "2023-04-03",
        "certification_date": "2023-04-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "OH",
            "license": "OTA008325",
            "primary": false
        },
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "FL",
            "license": "OTA19370",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tarpon Springs, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2023; 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.