Mikaela Elyse Kirby, OTD, OTR/L

Primary specialty

Pediatric Occupational TherapistTaxonomy code 225XP0200X

License

OTH-007871 Issued in AZ

Practice address

42211 N 41St Dr Ste 145
Anthem, AZ 85086-3812

Phone

(602) 808-9912

NPI assigned

Aug 8, 2019

Last updated

May 17, 2021By the provider in NPPES

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)

Enrolled

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• United Cerebral Palsy Association of Central Arizona

  • Developmentally Disabled Services Day Training Agency
  • Phoenix, AZ
  • NPI 1982673992
  NPD (past)

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

{
    "created_epoch": "1565222400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1621209600000",
    "number": "1083269625",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "41940 N 3RD ST",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850868607",
            "telephone_number": "623-255-9934"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "42211 N 41ST DR STE 145",
            "city": "ANTHEM",
            "state": "AZ",
            "postal_code": "850863812",
            "telephone_number": "602-808-9912"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIRBY",
        "first_name": "MIKAELA",
        "middle_name": "ELYSE",
        "credential": "OTD, OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-08-08",
        "last_updated": "2021-05-17",
        "certification_date": "2021-05-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "AZ",
            "license": "OTH-007871",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gayle Jumper
• JWT Medical PLC
• Natalie C Kahle, FNP-C
• Ida Kargar
• Ashwaq A. Kayat, DDS
• Stephen Kittridge, LCSW
• Robert Bradley Kohl, DDS
• Tatum Kolicko
• Daniel Gregory Koman, DDS
• La Pietra Geralyn La Pietra, M.S., CCC-SLP

• Pediatric Occupational Therapist in Anthem, AZ
• Providers in Anthem, AZ by specialty
• Pediatric Occupational Therapist in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 17, 2021; 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.