Individual provider Active NPI

Kayla Frederick, OTR

  • Occupational Therapist
  • Wooster, OH
National Provider Identifier
1073111340
Registry record updated Oct 9, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
011231 Issued in OH
Practice address
2714 Akron Rd
Wooster, OH 44691-7933
Phone
(330) 262-4449
Fax
(330) 262-4449
NPI assigned
Oct 9, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 9, 2020

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 011231 OH Primary

Addresses

Primary practice location

2714 Akron Rd
Wooster, OH 44691-7933

Mailing address

1398 N Milburn SQ NE
Bolivar, OH 44612-8660
Phone (330) 324-2420

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL ejtherapy

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
011231OHMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Ej Therapy, Inc. Occupational Therapist CurrentSince Jun 8, 2025 Accepting new patients
Ej Therapy, Inc. CurrentSince Jun 23, 2025 Accepting new patients

Locations

2714 Akron Rd
Wooster, OH 44691
Phone (330) 262-4449

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": "1602201600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1602201600000",
    "number": "1073111340",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1398 N MILBURN SQ NE",
            "city": "BOLIVAR",
            "state": "OH",
            "postal_code": "446128660",
            "telephone_number": "330-324-2420"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2714 AKRON RD",
            "city": "WOOSTER",
            "state": "OH",
            "postal_code": "446917933",
            "telephone_number": "330-262-4449",
            "fax_number": "330-262-4449"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FREDERICK",
        "first_name": "KAYLA",
        "credential": "OTR",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-10-09",
        "last_updated": "2020-10-09",
        "certification_date": "2020-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "OH",
            "license": "011231",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "ejtherapy",
            "affiliation": "N",
            "address_1": "2714 Akron Rd",
            "city": "Wooster",
            "state": "OH",
            "country_code": "US",
            "postal_code": "446917933",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Wooster, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2020; 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.