Individual provider Active NPI

Kaitlyn Danielle Martin, OTR/L

  • Occupational Therapist
  • Madison, MS
National Provider Identifier
1154843381
Registry record updated Mar 25, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
OT3385 Issued in MS
Practice address
119 Colony Crossing Way Ste 820
Madison, MS 39110-6330
Phone
(769) 289-2890
Fax
(769) 289-2891
NPI assigned
Jul 10, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 25, 2026

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 OT3385 MS Primary

Addresses

Primary practice location

119 Colony Crossing Way Ste 820
Madison, MS 39110-6330

Mailing address

920 Municipal Dr
Brandon, MS 39042-2973
Phone (601) 724-8886

Other practice location 1

920 Municipal Dr
Brandon, MS 39042-2973
Phone (601) 724-8886

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210520001719 MS Practitioner - Occupational Therapist in Private Practice 5395144539 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Performance Therapy LLCGroup PAC ID 7012971047, 86 clinicians

Practice addresses (Care Compare)

1301 W Government St
Suite 104
Brandon, MS 39042-3196
Phone (601) 591-7535

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Peak Therapy LLC Occupational Therapist CurrentSince May 18, 2026 Accepting new patients
Performance Therapy LLC CurrentSince May 18, 2021 Accepting new patients
Laskin Therapy Group, P.a. PastSince Jun 12, 2022 Accepting new patients

Locations

920 Municipal Dr
Brandon, MS 39042
Phone (601) 724-8886

1301 W Government St
Ste 104
Brandon, MS 39042
Phone (601) 591-7535

119 Colony Crossing Way
Ste 820
Madison, MS 39110
Phone (769) 289-2890

720A 3rd St SW
Magee, MS 39111
Phone (601) 439-7042

921 W Beacon St
Philadelphia, MS 39350
Phone (601) 650-0002

1058 Holland Ave
Philadelphia, MS 39350
Phone (601) 650-0002

Organizations & group practices 3

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": "1499644800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1774396800000",
    "number": "1154843381",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "920 MUNICIPAL DR",
            "city": "BRANDON",
            "state": "MS",
            "postal_code": "390422973",
            "telephone_number": "601-724-8886",
            "fax_number": "601-724-8887"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "119 COLONY CROSSING WAY STE 820",
            "city": "MADISON",
            "state": "MS",
            "postal_code": "391106330",
            "telephone_number": "769-289-2890",
            "fax_number": "769-289-2891"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "920 Municipal Dr",
            "address_purpose": "LOCATION",
            "city": "Brandon",
            "state": "MS",
            "postal_code": "390422973",
            "country_code": "US",
            "telephone_number": "601-724-8886",
            "fax_number": "601-724-8887",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "KAITLYN",
        "middle_name": "DANIELLE",
        "name_prefix": "Mrs.",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-07-10",
        "last_updated": "2026-03-25",
        "certification_date": "2026-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "MS",
            "license": "OT3385",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Madison, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.