Individual provider Active NPI

Brandi Michelle Kinnan, OTR/L, CLT-LANA

  • Occupational Therapist
  • Denver, CO
National Provider Identifier
1053175448
Registry record updated Feb 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
OT.0003168 Issued in CO
Practice address
9303 E 61St PL
Denver, CO 80238-2341
Phone
(417) 689-4091
NPI assigned
Feb 7, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 7, 2024

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.0003168 CO Primary

Addresses

Primary practice location

9303 E 61St PL
Denver, CO 80238-2341

Mailing address

9303 E 61St PL
Denver, CO 80238-2341
Phone (417) 689-4091

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240226002337 CO Practitioner - Occupational Therapist in Private Practice 0648615096 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Roaming Rehab LLCGroup PAC ID 4082015235, 21 clinicians

Practice addresses (Care Compare)

Lakewood, CO 80232
Phone (716) 444-7751

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Roaming Rehab LLC Occupational Therapist CurrentSince Feb 12, 2024 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": "1707264000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707264000000",
    "number": "1053175448",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9303 E 61ST PL",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802382341",
            "telephone_number": "417-689-4091"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9303 E 61ST PL",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802382341",
            "telephone_number": "417-689-4091"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KINNAN",
        "first_name": "BRANDI",
        "middle_name": "MICHELLE",
        "credential": "OTR/L, CLT-LANA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-02-07",
        "last_updated": "2024-02-07",
        "certification_date": "2024-02-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "CO",
            "license": "OT.0003168",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Denver, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 2024; 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.