Individual provider Active NPI

Kaitlyn Landess, OTD, OTR/L

  • Occupational Therapist
  • Holly, MI
National Provider Identifier
1235746249
Registry record updated Jun 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
OTH-008184 Issued in AZ
Practice address
10483 Dixie Hwy
Holly, MI 48442-9311
Phone
(810) 771-7686
NPI assigned
Sep 24, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 4, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X OTH-008184 AZ Primary
Occupational Therapist 225X00000X 5201013699 MI

Addresses

Primary practice location

10483 Dixie Hwy
Holly, MI 48442-9311

Mailing address

10483 Dixie Hwy
Holly, MI 48442-9311
Phone (810) 771-7686

Other practice location 1

1190 W. Missouri Ave
Suite 100
Phoenix, AZ 85014
Phone (602) 393-0520

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240619000697 MI Practitioner - Occupational Therapist in Private Practice 3072932581 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Level 11 Physical TherapyGroup PAC ID 8527104835, 23 clinicians

Practice addresses (Care Compare)

10483 Dixie Hwy
Holly, MI 48442-9311
Phone (810) 771-7686

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Level Eleven Saginaw CurrentSince Mar 2, 2025 Accepting new patients
Level Eleven Saginaw, LLC CurrentSince Mar 2, 2025 Accepting new patients
Guiding Light OT, LLC Occupational Therapist Current Accepting new patients
Level 11 Physical Therapy CurrentSince Jun 24, 2024 Accepting new patients
Level Eleven Howell, LLC CurrentSince Mar 2, 2025 Accepting new patients
RWW Outpatient Rehab Services, LLC Occupational Therapist CurrentSince Mar 2, 2025 Accepting new patients
Level Eleven Howell CurrentSince Mar 2, 2025 Accepting new patients
RWW Outpatient Rehab Services, LLC Current Accepting new patients

Locations

805 N Whittington Pkwy
Ste 400
Louisville, KY 40222
Phone (502) 272-3438

10483 Dixie Hwy
Holly, MI 48442
Phone (810) 498-2301

1030 W Highland Rd
Howell, MI 48843
Phone (517) 546-9000

5815 Bay Rd
Ste 400
Saginaw, MI 48604
Phone (989) 447-2538

13331 15 Mile Rd
Sterling Heights, MI 48312
Phone (586) 788-0702

3420 West Rd
Trenton, MI 48183
Phone (734) 215-9569

Organizations & group practices 8

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1600905600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717459200000",
    "number": "1235746249",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10483 DIXIE HWY",
            "city": "HOLLY",
            "state": "MI",
            "postal_code": "484429311",
            "telephone_number": "810-771-7686"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10483 DIXIE HWY",
            "city": "HOLLY",
            "state": "MI",
            "postal_code": "484429311",
            "telephone_number": "810-771-7686"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1190 W. Missouri Ave",
            "address_2": "Suite 100",
            "address_purpose": "LOCATION",
            "city": "Phoenix",
            "state": "AZ",
            "postal_code": "85014",
            "country_code": "US",
            "telephone_number": "602-393-0520",
            "fax_number": "602-393-0523",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LANDESS",
        "first_name": "KAITLYN",
        "credential": "OTD, OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-09-24",
        "last_updated": "2024-06-04",
        "certification_date": "2024-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "AZ",
            "license": "OTH-008184",
            "primary": true
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "MI",
            "license": "5201013699",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Holly, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.