Individual provider Active NPI

Kayla Davis, OTR

  • Occupational Therapist
  • Greenwood, IN
National Provider Identifier
1093085136
Registry record updated Nov 29, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
31005155A Issued in IN
Practice address
3177 Meridian Parke Dr
Greenwood, IN 46142-9629
Phone
(317) 794-5334
NPI assigned
Jan 6, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 29, 2022

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 31005155A IN Primary

Addresses

Primary practice location

3177 Meridian Parke Dr
Greenwood, IN 46142-9629

Mailing address

915 Moonlight CT
Mooresville, IN 46158-7510
Phone (812) 686-9299

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20221222000560 IN Practitioner - Occupational Therapist in Private Practice 6103296884 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Aegis Group Practice LLCGroup PAC ID 5193036432, 399 clinicians

Practice addresses (Care Compare)

3177 Meridian Parke Dr
Greenwood, IN 46142-9629
Phone (800) 444-6845

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Aegis Group Practice LLC Occupational Therapist Current Accepting new patients
Aegis Group Practice LLC Occupational Therapist CurrentSince Nov 28, 2022 Accepting new patients
Aegis Group Practice LLC Occupational Therapist CurrentSince Nov 28, 2022 Accepting new patients
Vericare of Florida, Inc. Past Accepting new patients
Primesource Healthcare Systems, Inc. Past Accepting new patients

Locations

4933 Old Greenwood Rd
Fort Smith, AR 72903

98 N 10th St
Greencastle, IN 46135
Phone (765) 301-4642

Organizations & group practices 5

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": "1325808000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1669680000000",
    "number": "1093085136",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "915 MOONLIGHT CT",
            "city": "MOORESVILLE",
            "state": "IN",
            "postal_code": "461587510",
            "telephone_number": "812-686-9299"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3177 MERIDIAN PARKE DR",
            "city": "GREENWOOD",
            "state": "IN",
            "postal_code": "461429629",
            "telephone_number": "317-794-5334"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "KAYLA",
        "credential": "OTR",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-01-06",
        "last_updated": "2022-11-29",
        "certification_date": "2022-11-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "IN",
            "license": "31005155A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenwood, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 2022; 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.