Individual provider Active NPI

Haley Alexandra Kisor, OTD

  • Occupational Therapist
  • Liberty TWP, OH
National Provider Identifier
1174181564
Registry record updated Mar 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
Practice address
5572 Princeton Rd
Liberty TWP, OH 45011-9726
Phone
(513) 874-5505
NPI assigned
May 31, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 16, 2025

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 Primary

Addresses

Primary practice location

5572 Princeton Rd
Liberty TWP, OH 45011-9726

Mailing address

6490 West Rd
Maineville, OH 45039-8637
Phone (513) 324-6417

Other practice location 1

7947 Tartan Fields Dr
Dublin, OH 43017-8778
Phone (614) 530-8511

Other identifiers 1

IdentifierTypeStateIssuer
0442179MedicaidOH

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

Practice roles

OrganizationSpecialtyStatusNew patients
Lakota Local School District PastSince Jul 9, 2023 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1559260800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742083200000",
    "number": "1174181564",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6490 WEST RD",
            "city": "MAINEVILLE",
            "state": "OH",
            "postal_code": "450398637",
            "telephone_number": "513-324-6417"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5572 PRINCETON RD",
            "city": "LIBERTY TWP",
            "state": "OH",
            "postal_code": "450119726",
            "telephone_number": "513-874-5505"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7947 Tartan Fields Dr",
            "address_purpose": "LOCATION",
            "city": "Dublin",
            "state": "OH",
            "postal_code": "430178778",
            "country_code": "US",
            "telephone_number": "614-530-8511",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KISOR",
        "first_name": "HALEY",
        "middle_name": "ALEXANDRA",
        "credential": "OTD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-05-31",
        "last_updated": "2025-03-16",
        "certification_date": "2025-03-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0442179",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Liberty TWP, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 2025; 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.