Active NPI
Kristin Mardis, MSOT
- Occupational Therapist
- Fort Thomas, KY
National Provider Identifier
1154916542
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- Practice address
- 100 Carmel Manor Dr
Fort Thomas, KY 41075-2300 - Phone
- (859) 781-5111
- NPI assigned
- Mar 8, 2021
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 267999 | KY | |
| Occupational Therapist | 225X00000X | Primary |
Addresses
Primary practice location
100 Carmel Manor Dr
Fort Thomas, KY 41075-2300
Mailing address
954 Philadelphia St
Covington, KY 41011
Phone (859) 760-8387
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
| License | State | Type | Specialty |
|---|---|---|---|
| 267999 | KY | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1615161600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1615507200000",
"number": "1154916542",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "954 PHILADELPHIA ST",
"city": "COVINGTON",
"state": "KY",
"postal_code": "41011",
"telephone_number": "859-760-8387"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "100 CARMEL MANOR DR",
"city": "FORT THOMAS",
"state": "KY",
"postal_code": "410752300",
"telephone_number": "859-781-5111"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MARDIS",
"first_name": "KRISTIN",
"credential": "MSOT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-03-08",
"last_updated": "2021-03-12",
"certification_date": "2021-03-12",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "KY",
"license": "267999",
"primary": false
},
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fort Thomas, KY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.