Individual provider Active NPI

Kyle Courtney, OTR/L

  • Occupational Therapist
  • Evansville, IN
National Provider Identifier
1255842407
Registry record updated Jan 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
31008338A Issued in IN
Practice address
101 NW 1St St Ste 114
Evansville, IN 47708-1259
Phone
(812) 402-0444
NPI assigned
Oct 16, 2017
Last updated
Jan 2, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 2, 2025

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 OT006848 GA
Occupational Therapist 225X00000X 31008338A IN Primary

Addresses

Primary practice location

101 NW 1St St Ste 114
Evansville, IN 47708-1259

Mailing address

PO Box 3276
Evansville, IN 47731-3276
Phone (812) 473-0181

Other practice location 1

3044 Due West Rd
Dallas, GA 30157-2125
Phone (770) 443-9672

Other practice location 2

201 SE 4th St Ste 150
Evansville, IN 47713-1201
Phone (812) 461-6716

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250103000765 IN Practitioner - Occupational Therapist in Private Practice 2365979358 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OT006848GAMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Forefront Therapy LLC Occupational Therapist CurrentSince Dec 30, 2024 Accepting new patients
Forefront Community Therapy Inc Occupational Therapist CurrentSince Dec 30, 2024 Accepting new patients
Associates in Pediatric Therapy, LLC Occupational Therapist Past Accepting new patients

Locations

201 SE 4th St
#150
Evansville, IN 47713
Phone (812) 461-6716

101 NW 1st St
Ste 114
Evansville, IN 47708
Phone (812) 402-0444

Organizations & group practices 3

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": "1508112000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1735776000000",
    "number": "1255842407",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3276",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477313276",
            "telephone_number": "812-473-0181"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 NW 1ST ST STE 114",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477081259",
            "telephone_number": "812-402-0444"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3044 Due West Rd",
            "address_purpose": "LOCATION",
            "city": "Dallas",
            "state": "GA",
            "postal_code": "301572125",
            "country_code": "US",
            "telephone_number": "770-443-9672",
            "fax_number": "770-443-9672",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "201 SE 4th St Ste 150",
            "address_purpose": "LOCATION",
            "city": "Evansville",
            "state": "IN",
            "postal_code": "477131201",
            "country_code": "US",
            "telephone_number": "812-461-6716",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "COURTNEY",
        "first_name": "KYLE",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-10-16",
        "last_updated": "2025-01-02",
        "certification_date": "2025-01-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "GA",
            "license": "OT006848",
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "IN",
            "license": "31008338A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Evansville, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 2, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.