Active NPI
Kathryn Yvette McCormick, COTA
- Occupational Therapy Assistant
- Fort Wayne, IN
National Provider Identifier
1194157347
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapy Assistant
- License
- 32001856A
- Practice address
- 4835 Fairfield Ave
Fort Wayne, IN 46807-3273 - Phone
- (260) 515-1341
- NPI assigned
- Jul 30, 2013
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapy Assistant | 224Z00000X | 32001856A | IN | Primary |
Addresses
Primary practice location
4835 Fairfield Ave
Fort Wayne, IN 46807-3273
Mailing address
4835 Fairfield Ave
Fort Wayne, IN 46807-3273
Phone (260) 515-1341
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 |
|---|---|---|---|
| 32001856A | IN | MD | Occupational Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1375142400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1375142400000",
"number": "1194157347",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4835 FAIRFIELD AVE",
"city": "FORT WAYNE",
"state": "IN",
"postal_code": "468073273",
"telephone_number": "260-515-1341"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4835 FAIRFIELD AVE",
"city": "FORT WAYNE",
"state": "IN",
"postal_code": "468073273",
"telephone_number": "260-515-1341"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCCORMICK",
"first_name": "KATHRYN",
"middle_name": "YVETTE",
"name_prefix": "Ms.",
"credential": "COTA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-07-30",
"last_updated": "2013-07-30",
"status": "A"
},
"taxonomies": [
{
"code": "224Z00000X",
"taxonomy_group": "",
"desc": "Occupational Therapy Assistant",
"state": "IN",
"license": "32001856A",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fort Wayne, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.