Kristen M Perez, COTA/L

Primary specialty

Occupational Therapy AssistantTaxonomy code 224Z00000X

License

5073 Issued in SC

Practice address

491 Highway 17
Little River, SC 29566-8082

Phone

(843) 399-6454

Fax

(843) 399-6463

NPI assigned

May 28, 2021

Last updated

May 28, 2021By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Interoperability endpoints

• Direct secure messaging: kperez1@5ssl.com

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

{
    "created_epoch": "1622160000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1622160000000",
    "number": "1205402476",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6015 CATALINA DR UNIT 713",
            "city": "NORTH MYRTLE BEACH",
            "state": "SC",
            "postal_code": "295829514",
            "telephone_number": "843-582-8014"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "491 HIGHWAY 17",
            "city": "LITTLE RIVER",
            "state": "SC",
            "postal_code": "295668082",
            "telephone_number": "843-399-6454",
            "fax_number": "843-399-6463"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEREZ",
        "first_name": "KRISTEN",
        "middle_name": "M",
        "credential": "COTA/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-05-28",
        "last_updated": "2021-05-28",
        "certification_date": "2021-05-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "SC",
            "license": "5073",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Kperez1@5ssl.com",
            "affiliation": "Y",
            "endpointDescription": "email",
            "affiliationName": "Five star senior living",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "491 Highway 17",
            "city": "Little River",
            "state": "SC",
            "country_code": "US",
            "postal_code": "295668082",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Ami Pankaj Patel, PT
• Niyanta Himanshu Patel, MD
• Emanuela Pavliqoti, MD
• Jodi S Peavy, LISW-CP
• Paul Percelay, MD
• Michael D Peters, M.D.
• Thirston S Phillips Jr., DO
• Heather Pitt
• Georgia Lynn Plum, APRN
• Robert Allan Prinzi, MD

• Occupational Therapy Assistant in Little River, SC
• Providers in Little River, SC by specialty
• Occupational Therapy Assistant in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 2021; 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.