Active NPI
Kaelyn King
- Occupational Therapist
- Mesa, AZ
National Provider Identifier
1245995844
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- OTH-010233
- Practice address
- 63 E Main St
Mesa, AZ 85201-7417 - Phone
- (480) 472-0000
- NPI assigned
- Nov 8, 2021
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | OTH-010233 | AZ | Primary |
Addresses
Primary practice location
63 E Main St
Mesa, AZ 85201-7417
Mailing address
63 E Main St
Mesa, AZ 85201-7417
Phone (480) 472-0000
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
| License | State | Type | Specialty |
|---|---|---|---|
| OTH-010233 | AZ | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1636329600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1765843200000",
"number": "1245995844",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "63 E MAIN ST",
"city": "MESA",
"state": "AZ",
"postal_code": "852017417",
"telephone_number": "480-472-0000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "63 E MAIN ST",
"city": "MESA",
"state": "AZ",
"postal_code": "852017417",
"telephone_number": "480-472-0000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KING",
"first_name": "KAELYN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-11-08",
"last_updated": "2025-12-16",
"certification_date": "2025-12-16",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "AZ",
"license": "OTH-010233",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Mesa, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 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.