Active NPI
Kaitlyn Haldeman, MS, OTR/L
- Occupational Therapist
- Worcester, MA
National Provider Identifier
1316483456
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 12162
- Practice address
- 484 Main St
Worcester, MA 01608-1893 - Phone
- (800) 244-2756
- Fax
- (508) 831-9768
- NPI assigned
- Jan 12, 2017
- Last updated
- Jan 12, 2017
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | OC013997 | PA | |
| Occupational Therapist | 225X00000X | 12162 | MA | Primary |
Addresses
Primary practice location
484 Main St
Worcester, MA 01608-1893
Mailing address
23 Windermere Rd Unit 1
Dorchester, MA 02125-2015
Phone (484) 560-9997
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
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 12162 | MA | MD | Mental Health Counselor |
| OC013997 | PA | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1484179200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1484179200000",
"number": "1316483456",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "23 WINDERMERE RD UNIT 1",
"city": "DORCHESTER",
"state": "MA",
"postal_code": "021252015",
"telephone_number": "484-560-9997",
"fax_number": "508-831-9768"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "484 MAIN ST",
"city": "WORCESTER",
"state": "MA",
"postal_code": "016081893",
"telephone_number": "800-244-2756",
"fax_number": "508-831-9768"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HALDEMAN",
"first_name": "KAITLYN",
"name_prefix": "Miss",
"credential": "MS, OTR/L",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2017-01-12",
"last_updated": "2017-01-12",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "PA",
"license": "OC013997",
"primary": false
},
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "MA",
"license": "12162",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Worcester, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.