Individual provider Active NPI

Kylie Large, COTA

  • Feeding, Eating & Swallowing Occupational Therapy Assistant
  • Stillwater, OK
National Provider Identifier
1184377509
Registry record updated Jan 27, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Feeding, Eating & Swallowing Occupational Therapy AssistantTaxonomy code 224ZF0002X
Practice address
811 E Virginia Ave
Stillwater, OK 74075-7919
Phone
(405) 377-8255
NPI assigned
Jan 27, 2022
Last updated
Jan 27, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 27, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Feeding, Eating & Swallowing Occupational Therapy Assistant 224ZF0002X Primary

Addresses

Primary practice location

811 E Virginia Ave
Stillwater, OK 74075-7919

Mailing address

811 E Virginia Ave
Stillwater, OK 74075-7919
Phone (405) 377-8255

Other practice location 1

220 Village Cir
Ponca City, OK 74601-4021
Phone (580) 762-0121

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
Dysphagia Specialists, PLLC CurrentSince Feb 1, 2022 Accepting new patients
Children S Therapy Zone LLC PastSince Oct 25, 2020 Accepting new patients

Locations

811 E Virginia Ave
Stillwater, OK 74075
Phone (405) 377-8255

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1643241600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643241600000",
    "number": "1184377509",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "811 E VIRGINIA AVE",
            "city": "STILLWATER",
            "state": "OK",
            "postal_code": "740757919",
            "telephone_number": "405-377-8255"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "811 E VIRGINIA AVE",
            "city": "STILLWATER",
            "state": "OK",
            "postal_code": "740757919",
            "telephone_number": "405-377-8255"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "220 Village Cir",
            "address_purpose": "LOCATION",
            "city": "Ponca City",
            "state": "OK",
            "postal_code": "746014021",
            "country_code": "US",
            "telephone_number": "580-762-0121",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LARGE",
        "first_name": "KYLIE",
        "credential": "COTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-01-27",
        "last_updated": "2022-01-27",
        "certification_date": "2022-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224ZF0002X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant, Feeding, Eating & Swallowing",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stillwater, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2022; 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.