Organization Active NPI

Kids in Motion Mobile Pediatric Therapy LLC

  • Pediatric Occupational Therapist
  • Yukon, OK
National Provider Identifier
1316658065
Registry record updated Dec 13, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Occupational TherapistTaxonomy code 225XP0200X
Legal business name
KIDS IN MOTION MOBILE PEDIATRIC THERAPY LLC
Practice address
10613 NW 38TH St
Yukon, OK 73099-6003
Phone
(405) 627-3159
NPI assigned
Dec 13, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 13, 2022

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

Authorized official

Name
Candy Ann McLeister, OTR/LNPI 1912314550
Title
Owner
Phone
(405) 627-3159

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Occupational TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225XP0200X Primary

Addresses

Primary practice location

10613 NW 38TH St
Yukon, OK 73099-6003

Mailing address

10613 NW 38TH St
Yukon, OK 73099-6003
Phone (405) 627-3159

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL https://www.facebook.com/profile.php?id=100088921021581

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230329001346 OK Part B Supplier - Physical/Occupational Therapy Group in Private Practice 8325412539 Receives reassigned benefits from 1 practitioner
Practice locations: Yukon, OK

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1670889600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1670889600000",
    "number": "1316658065",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10613 NW 38TH ST",
            "city": "YUKON",
            "state": "OK",
            "postal_code": "730996003",
            "telephone_number": "405-627-3159"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10613 NW 38TH ST",
            "city": "YUKON",
            "state": "OK",
            "postal_code": "730996003",
            "telephone_number": "405-627-3159"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KIDS IN MOTION MOBILE PEDIATRIC THERAPY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-12-13",
        "last_updated": "2022-12-13",
        "certification_date": "2022-12-13",
        "status": "A",
        "authorized_official_last_name": "MCLEISTER",
        "authorized_official_first_name": "CANDY",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "405-627-3159",
        "authorized_official_credential": "OTR/L"
    },
    "taxonomies": [
        {
            "code": "225XP0200X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Occupational Therapist, Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "https://www.facebook.com/profile.php?id=100088921021581",
            "affiliation": "N",
            "address_1": "10613 NW 38th St",
            "city": "Yukon",
            "state": "OK",
            "country_code": "US",
            "postal_code": "730996003",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Yukon, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2022; 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.