Individual provider Active NPI

Katelyn Ilene Gilley, MSOT

  • Occupational Therapist
  • Kent, WA
National Provider Identifier
1285356006
Registry record updated Jul 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
Practice address
25012 104TH Ave SE Ste C
Kent, WA 98030-2821
Phone
(253) 856-3477
Fax
(253) 856-3478
NPI assigned
Sep 19, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 16, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Occupational Therapist 225XP0200X 123036 TX
Occupational Therapist 225X00000X WA Primary

Addresses

Primary practice location

25012 104TH Ave SE Ste C
Kent, WA 98030-2821

Mailing address

790 Remington Blvd
Bolingbrook, IL 60440-4909

Other practice location 1

12708 Riata Vista Cir Ste A106
Austin, TX 78727-7174
Phone (512) 795-2422

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240729000189 WA Practitioner - Occupational Therapist in Private Practice 0345786141 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Apple Physical Therapy LLCGroup PAC ID 7810892072, 285 clinicians

Practice addresses (Care Compare)

25012 104TH Ave SE
Suite C
Kent, WA 98030-2821
Phone (253) 856-3477

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
123036TXMDPediatric Occupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Apple Physical Therapy, LLC Occupational Therapist CurrentSince Aug 19, 2024 Accepting new patients
Apple Physical Therapy LLC Occupational Therapist CurrentSince Aug 19, 2024 Accepting new patients

Locations

790 Remington Blvd
Bolingbrook, IL 60440

4947 Paysphere Cir
Chicago, IL 60674
Phone (630) 783-2001

4220 Hoyt Ave
Everett, WA 98203
Phone (425) 258-5330

32030 23rd Ave S
Federal Way, WA 98003
Phone (253) 946-4852

25012 104th Ave SE
Ste C
Kent, WA 98030
Phone (253) 856-3477

130 Marvin Rd SE
Ste 203
Lacey, WA 98503
Phone (360) 456-3300

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1663545600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721088000000",
    "number": "1285356006",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "790 REMINGTON BLVD",
            "city": "BOLINGBROOK",
            "state": "IL",
            "postal_code": "604404909"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25012 104TH AVE SE STE C",
            "city": "KENT",
            "state": "WA",
            "postal_code": "980302821",
            "telephone_number": "253-856-3477",
            "fax_number": "253-856-3478"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "12708 Riata Vista Cir Ste A106",
            "address_purpose": "LOCATION",
            "city": "Austin",
            "state": "TX",
            "postal_code": "787277174",
            "country_code": "US",
            "telephone_number": "512-795-2422",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GILLEY",
        "first_name": "KATELYN",
        "middle_name": "ILENE",
        "credential": "MSOT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-09-19",
        "last_updated": "2024-07-16",
        "certification_date": "2024-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "TX",
            "license": "123036",
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "WA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kent, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.