Individual provider Active NPI

Kade Neal Dillon, COTA

  • Environmental Modification Occupational Therapy Assistant
  • Gahanna, OH
National Provider Identifier
1225636962
Registry record updated Oct 14, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Environmental Modification Occupational Therapy AssistantTaxonomy code 224ZE0001X
License
05395 Issued in OH
Practice address
402 Liberty Way
Gahanna, OH 43230-3502
Phone
(614) 632-7794
Fax
(614) 831-2614
NPI assigned
Oct 14, 2020
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 14, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Environmental Modification Occupational Therapy Assistant 224ZE0001X 05395 OH Primary

Addresses

Primary practice location

402 Liberty Way
Gahanna, OH 43230-3502

Mailing address

272 Harmony Dr
Delaware, OH 43015-4333
Phone (740) 513-8725

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

LicenseStateTypeSpecialty
05395OHMDEnvironmental Modification Occupational Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1602633600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1602633600000",
    "number": "1225636962",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "272 HARMONY DR",
            "city": "DELAWARE",
            "state": "OH",
            "postal_code": "430154333",
            "telephone_number": "740-513-8725"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "402 LIBERTY WAY",
            "city": "GAHANNA",
            "state": "OH",
            "postal_code": "432303502",
            "telephone_number": "614-632-7794",
            "fax_number": "614-831-2614"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DILLON",
        "first_name": "KADE",
        "middle_name": "NEAL",
        "credential": "COTA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-10-14",
        "last_updated": "2020-10-14",
        "certification_date": "2020-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224ZE0001X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant, Environmental Modification",
            "state": "OH",
            "license": "05395",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gahanna, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2020; 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.