Kgatale Siko Malatse

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

Practice address

3811 Parnell Ave
Fort Wayne, IN 46805-1409

Phone

(260) 482-4651

NPI assigned

Jul 3, 2007

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

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.

• A Step Ahead Therapies, LLC

  • Specialist
  • Fort Wayne, IN
  • NPI 1033376413
  NPD (past) Authorized official

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

{
    "created_epoch": "1183420800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1174721971",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6013 BELLE ISLE LN",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468351263",
            "telephone_number": "260-492-6420"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3811 PARNELL AVE",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468051409",
            "telephone_number": "260-482-4651"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MALATSE",
        "first_name": "KGATALE",
        "middle_name": "SIKO",
        "name_prefix": "Mr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-07-03",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100266090",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Major Hospital (Elevate Senior Living - Fort Wayne)
• Timothy Major, RBT
• Brenda Renee Majors
• Stephanie Majors, LPN
• Make Mi Gorgeous
• Jaipal Malhi
• Isa Malik, MD
• Mallers & Swoverland Orthopaedic Physical Therapy
• Douglas J. Mallers, P.T.
• Katherine Mallers, M.A. CCC-SLP

• Occupational Therapist in Fort Wayne, IN
• Providers in Fort Wayne, IN by specialty
• Occupational Therapist in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.