Kathryn Ann Park, OTR/L

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

020619 Issued in NY

Practice address

1500 Brecknock Rd
Greenport, NY 11944-3117

Phone

(631) 477-3800

NPI assigned

Aug 8, 2017

Last updated

Aug 8, 2017By 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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1502150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1502150400000",
    "number": "1245755537",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "870 CHESTNUT RD",
            "city": "SOUTHOLD",
            "state": "NY",
            "postal_code": "119712468",
            "telephone_number": "631-882-2113"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 BRECKNOCK RD",
            "city": "GREENPORT",
            "state": "NY",
            "postal_code": "119443117",
            "telephone_number": "631-477-3800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARK",
        "first_name": "KATHRYN",
        "middle_name": "ANN",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-08-08",
        "last_updated": "2017-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NY",
            "license": "020619",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Occupational Therapist in Greenport, NY
• Providers in Greenport, NY by specialty
• Occupational Therapist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2017; 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.