Individual provider Active NPI

Mackenzie Dean

  • Occupational Therapist
  • La Grange, KY
National Provider Identifier
1093677403
Registry record updated Nov 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
244900 Issued in KY
Practice address
4603 Timberwalk CT
La Grange, KY 40031-6746
Phone
(606) 407-1639
NPI assigned
Nov 25, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 25, 2025

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 244900 KY Primary

Addresses

Primary practice location

4603 Timberwalk CT
La Grange, KY 40031-6746

Mailing address

130 Chandler Dr
Danville, KY 40422-8449

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
244900KYMDOccupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1764028800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1764028800000",
    "number": "1093677403",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "130 CHANDLER DR",
            "city": "DANVILLE",
            "state": "KY",
            "postal_code": "404228449"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4603 TIMBERWALK CT",
            "city": "LA GRANGE",
            "state": "KY",
            "postal_code": "400316746",
            "telephone_number": "606-407-1639"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEAN",
        "first_name": "MACKENZIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-11-25",
        "last_updated": "2025-11-25",
        "certification_date": "2025-11-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "KY",
            "license": "244900",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in La Grange, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 25, 2025; 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.