Kristyn Marie McGowan, MOT, OTR/L

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

5201007580 Issued in MI

Practice address

14382 Stonehouse Ave
Livonia, MI 48154-4945

Phone

(248) 207-1945

NPI assigned

Jan 14, 2019

Sex

Female

Sole proprietor

Yes

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

Enrolled in MI

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Ivyrehab Michigan, LLC

  • Sports Medicine (Physical Medicine & Rehabilitation) Physician
  • Fenton, MI
  • NPI 1104337120
  Medicare reassignment
• Inspire Occupational Therapy PLLC

  • Occupational Therapist
  • Livonia, MI
  • NPI 1811551856
  NPD (past)

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

{
    "created_epoch": "1547424000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635379200000",
    "number": "1275007247",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14382 STONEHOUSE AVE",
            "city": "LIVONIA",
            "state": "MI",
            "postal_code": "481544945",
            "telephone_number": "248-207-1945"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14382 STONEHOUSE AVE",
            "city": "LIVONIA",
            "state": "MI",
            "postal_code": "481544945",
            "telephone_number": "248-207-1945"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCGOWAN",
        "first_name": "KRISTYN",
        "middle_name": "MARIE",
        "name_prefix": "Ms.",
        "credential": "MOT, OTR/L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-01-14",
        "last_updated": "2021-10-28",
        "certification_date": "2021-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "MI",
            "license": "5201007580",
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "MI",
            "license": "5201007580",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Thamesa McFadden
• Mary Katherine McFeters, CPNP
• Katelynn McGee
• Talaya McGee
• Eryn McGinnis, OTRL
• Kelsey McHugh
• Dallas McIntosh
• Gregory V McIntosh, D.O.
• Nicole McIntyre
• Latavia McKinney

• Occupational Therapist in Livonia, MI
• Providers in Livonia, MI by specialty
• Occupational Therapist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2021; 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.