Kyle David Welch

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

122639 Issued in TX

Practice address

4524 Boat Club Rd Ste 180
Fort Worth, TX 76135-7025

Phone

(817) 764-3825

NPI assigned

Feb 19, 2016

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Little Red Wagon Pediatric Therapy, LLC

  • Speech-Language Pathologist
  • Fort Worth, TX
  • NPI 1831569052
  NPD

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

{
    "created_epoch": "1455840000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1732060800000",
    "number": "1255790150",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8325 RED ROSE TRL",
            "city": "NORTH RICHLAND HILLS",
            "state": "TX",
            "postal_code": "761828421",
            "telephone_number": "714-403-9382"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4524 BOAT CLUB RD STE 180",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761357025",
            "telephone_number": "817-764-3825"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WELCH",
        "first_name": "KYLE",
        "middle_name": "DAVID",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-02-19",
        "last_updated": "2024-11-20",
        "certification_date": "2024-11-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "CA",
            "license": "16020",
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "TX",
            "license": "122639",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elissa Michelle Weixel
• Alicia Welborn, OTR
• Miranda Welborn
• Elizabeth Welch, RN, ACNS-BC
• Kristina Welch
• Lacey Welch, PT, DPT
• Meagan Denise Welch, M.S.
• Rhonda Sue Welch, LPC
• Kibrom S Weldemichael
• Weldon Medical Clinic PA

• Occupational Therapist in Fort Worth, TX
• Providers in Fort Worth, TX by specialty
• Occupational Therapist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2024; 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.