Active NPI
Kerrie Jane Gates, MS OTR/L
- Pediatric Occupational Therapist
- Cypress, CA
National Provider Identifier
1134462500
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Occupational Therapist
- License
- 12200
- Practice address
- 11105 Knott Ave Ste a
Cypress, CA 90630-5137 - Phone
- (714) 893-7399
- NPI assigned
- Apr 3, 2013
- Last updated
- Apr 3, 2013
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Occupational Therapist | 225XP0200X | 12200 | CA | Primary |
Addresses
Primary practice location
11105 Knott Ave Ste a
Cypress, CA 90630-5137
Mailing address
468 Ogle St
Costa Mesa, CA 92627-3244
Phone (949) 378-4794
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
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 12200 | CA | MD | Pediatric Occupational Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| South Coast Pediatric Physical Therapy, Inc | Pediatrics | Past | Accepting new patients |
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.
-
- Speech-Language Pathologist
- Cypress, CA
- NPI 1467604694
Pediatrics
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1364947200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1364947200000",
"number": "1134462500",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "468 OGLE ST",
"city": "COSTA MESA",
"state": "CA",
"postal_code": "926273244",
"telephone_number": "949-378-4794"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11105 KNOTT AVE STE A",
"city": "CYPRESS",
"state": "CA",
"postal_code": "906305137",
"telephone_number": "714-893-7399"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GATES",
"first_name": "KERRIE",
"middle_name": "JANE",
"credential": "MS OTR/L",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-04-03",
"last_updated": "2013-04-03",
"status": "A"
},
"taxonomies": [
{
"code": "225XP0200X",
"taxonomy_group": "",
"desc": "Occupational Therapist, Pediatrics",
"state": "CA",
"license": "12200",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Cypress, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.