Individual provider Active NPI

Lauren Blake Kain

  • Occupational Therapy Assistant
  • Dallas, TX
National Provider Identifier
1104437409
Registry record updated Aug 11, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Therapy AssistantTaxonomy code 224Z00000X
License
216268 Issued in TX
Practice address
17480 Dallas Pkwy Ste 221
Dallas, TX 75287-7361
Phone
(469) 291-8500
Fax
(866) 341-4918
NPI assigned
Aug 11, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 11, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy AssistantGroup: 193400000X SINGLE SPECIALTY GROUP 224Z00000X 216268 TX Primary

Addresses

Primary practice location

17480 Dallas Pkwy Ste 221
Dallas, TX 75287-7361

Mailing address

5220 Spring Valley Rd Ste 400
Dallas, TX 75254-2512
Phone (214) 466-1340

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
216268TXMDOccupational Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1597104000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597104000000",
    "number": "1104437409",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5220 SPRING VALLEY RD STE 400",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752542512",
            "telephone_number": "214-466-1340",
            "fax_number": "214-466-1378"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17480 DALLAS PKWY STE 221",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752877361",
            "telephone_number": "469-291-8500",
            "fax_number": "866-341-4918"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAIN",
        "first_name": "LAUREN",
        "middle_name": "BLAKE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-08-11",
        "last_updated": "2020-08-11",
        "certification_date": "2020-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Occupational Therapy Assistant",
            "state": "TX",
            "license": "216268",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 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.