Individual provider Active NPI

Kaylan Kane

  • Occupational Therapist
  • Dover, DE
National Provider Identifier
1104566330
Registry record updated Mar 29, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
U1-0012352 Issued in DE
Practice address
100 Enterprise PL Ste 1
Dover, DE 19904-8202
Phone
(302) 678-3353
NPI assigned
Mar 29, 2022
Last updated
Mar 29, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 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 U1-0012352 DE Primary

Addresses

Primary practice location

100 Enterprise PL Ste 1
Dover, DE 19904-8202

Mailing address

501 S Stone Brook LN
Wilmington, DE 19807-2048
Phone (585) 690-0745

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240923000819 DE Practitioner - Occupational Therapist in Private Practice 6305387036 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
U1-0012352DEMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Easter Seals Delaware & Marylands Eastern Shore, Inc Occupational Therapist CurrentSince Jun 30, 2024 Accepting new patients

Locations

100 Enterprise Pl
Ste 1
Dover, DE 19904
Phone (302) 678-3353

61 Corporate Cir
New Castle, DE 19720
Phone (302) 221-2076

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1648512000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1648512000000",
    "number": "1104566330",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "501 S STONE BROOK LN",
            "city": "WILMINGTON",
            "state": "DE",
            "postal_code": "198072048",
            "telephone_number": "585-690-0745"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 ENTERPRISE PL STE 1",
            "city": "DOVER",
            "state": "DE",
            "postal_code": "199048202",
            "telephone_number": "302-678-3353"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KANE",
        "first_name": "KAYLAN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-03-29",
        "last_updated": "2022-03-29",
        "certification_date": "2022-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "DE",
            "license": "U1-0012352",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dover, DE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 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.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.