Kenneth Charles Dean, COTA/L

Primary specialty

Gerontology Occupational TherapistTaxonomy code 225XG0600X

License

214817 Issued in TX

Practice address

8924 Bayonne Dr
Shreveport, LA 71118-2033

Phone

(318) 294-1952

NPI assigned

Jan 30, 2019

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1548806400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1548806400000",
    "number": "1184188435",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "127 W BROAD ST",
            "city": "LAKE CHARLES",
            "state": "LA",
            "postal_code": "706014393"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8924 BAYONNE DR",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711182033",
            "telephone_number": "318-294-1952"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEAN",
        "first_name": "KENNETH",
        "middle_name": "CHARLES",
        "credential": "COTA/L",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-01-30",
        "last_updated": "2019-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XG0600X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Gerontology",
            "state": "TX",
            "license": "214817",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Dean a. Darr, D.C., P.a.
• Andrea M. Dean, AUD
• Tonya Denise Dean
• Deanna Donley MD and Willis-Knighton Medical Center
• Charles Corey Deans
• Cynthia Dear-Owen, LMSW
• David Collins Deas, MD

• Gerontology Occupational Therapist in Shreveport, LA
• Providers in Shreveport, LA by specialty
• Gerontology Occupational Therapist in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2019; 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.