Individual provider Active NPI

Kayla Param

  • Occupational Therapy Assistant
  • Moncks Corner, SC
National Provider Identifier
1225924046
Registry record updated Jun 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Therapy AssistantTaxonomy code 224Z00000X
License
5803 Issued in SC
Practice address
421 Barony St Ste 3
Moncks Corner, SC 29461-3145
Phone
(843) 790-4093
NPI assigned
Jun 17, 2025
Last updated
Jun 17, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 17, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy Assistant 224Z00000X 5803 SC Primary

Addresses

Primary practice location

421 Barony St Ste 3
Moncks Corner, SC 29461-3145

Mailing address

421 Barony St Ste 3
Moncks Corner, SC 29461-3145
Phone (843) 790-4093

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
5803SCMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Vantage Early Intervention, LLC CurrentSince Jun 23, 2025 Accepting new patients
Vantage Speech & Language LLC CurrentSince Jun 23, 2025 Accepting new patients

Locations

421 Barony St
Ste 3
Moncks Corner, SC 29461
Phone (843) 513-4960

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": "1750118400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750118400000",
    "number": "1225924046",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "421 BARONY ST STE 3",
            "city": "MONCKS CORNER",
            "state": "SC",
            "postal_code": "294613145",
            "telephone_number": "843-790-4093"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "421 BARONY ST STE 3",
            "city": "MONCKS CORNER",
            "state": "SC",
            "postal_code": "294613145",
            "telephone_number": "843-790-4093"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARAM",
        "first_name": "KAYLA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-06-17",
        "last_updated": "2025-06-17",
        "certification_date": "2025-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "SC",
            "license": "5803",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Moncks Corner, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2025; 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.