Active NPI
Kloe Kukta Dorn, OTD, OTR/L,
- Pediatric Occupational Therapist
- Cleveland, TN
National Provider Identifier
1346926904
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Occupational Therapist
- License
- 7694
- Practice address
- 65 Mouse Creek Rd NW
Cleveland, TN 37312-4840 - Phone
- (423) 476-7212
- NPI assigned
- Jun 27, 2023
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Occupational Therapist | 225XP0200X | 7694 | TN | Primary |
Addresses
Primary practice location
65 Mouse Creek Rd NW
Cleveland, TN 37312-4840
Mailing address
172 Joan Dr
Ringgold, GA 30736-6543
Phone (423) 394-2633
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 7694 | TN | MD | Pediatric Occupational Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Can DO Kids Pediatric Therapy Services, LLC | Pediatrics | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Pediatric Occupational Therapist
- Cleveland, TN
- NPI 1033593785
Pediatrics
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1687824000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1729468800000",
"number": "1346926904",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "172 JOAN DR",
"city": "RINGGOLD",
"state": "GA",
"postal_code": "307366543",
"telephone_number": "423-394-2633"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "65 MOUSE CREEK RD NW",
"city": "CLEVELAND",
"state": "TN",
"postal_code": "373124840",
"telephone_number": "423-476-7212"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DORN",
"first_name": "KLOE",
"middle_name": "KUKTA",
"credential": "OTD, OTR/L,",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-06-27",
"last_updated": "2024-10-21",
"certification_date": "2024-10-21",
"status": "A"
},
"taxonomies": [
{
"code": "225XP0200X",
"taxonomy_group": "",
"desc": "Occupational Therapist, Pediatrics",
"state": "TN",
"license": "7694",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Cleveland, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.