Individual provider Active NPI

Kerry Taylor, OTR-L

  • Occupational Therapist
  • San Tan Valley, AZ
National Provider Identifier
1154481414
Registry record updated Oct 5, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
2670 Issued in AZ
Practice address
29755 N Varnum Rd
San Tan Valley, AZ 85143-7007
Phone
(480) 239-5741
Fax
(480) 635-0222
NPI assigned
Dec 9, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 5, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Occupational Therapist 225XP0200X 2670 AZ
Occupational Therapist 225X00000X 2670 AZ Primary

Addresses

Primary practice location

29755 N Varnum Rd
San Tan Valley, AZ 85143-7007

Mailing address

29755 N Varnum Rd
San Tan Valley, AZ 85143-7007
Phone (480) 239-5741

Other identifiers 1

IdentifierTypeStateIssuer
539380MedicaidAZ

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
2670AZMDPediatric Occupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Horizon Pediatric Therapy, Inc. Pediatrics Past Accepting new patients
Bright Horizon Rehab Therapy, LLC Occupational Therapist Past Accepting new patients

Organizations & group practices 2

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": "1165622400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696464000000",
    "number": "1154481414",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29755 N VARNUM RD",
            "city": "SAN TAN VALLEY",
            "state": "AZ",
            "postal_code": "851437007",
            "telephone_number": "480-239-5741",
            "fax_number": "480-635-0222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "29755 N VARNUM RD",
            "city": "SAN TAN VALLEY",
            "state": "AZ",
            "postal_code": "851437007",
            "telephone_number": "480-239-5741",
            "fax_number": "480-635-0222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAYLOR",
        "first_name": "KERRY",
        "credential": "OTR-L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-12-09",
        "last_updated": "2023-10-05",
        "certification_date": "2023-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "AZ",
            "license": "2670",
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "AZ",
            "license": "2670",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "539380",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Tan Valley, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2023; 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.