Individual provider Active NPI

Kylea Joy Bachelder, COTA/L

  • Occupational Therapy Assistant
  • Charleston, SC
National Provider Identifier
1346928108
Registry record updated Jul 10, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Therapy AssistantTaxonomy code 224Z00000X
License
OTA.5561 Issued in SC
Practice address
1849 Capri Dr
Charleston, SC 29407-7603
Phone
(843) 224-3885
Fax
(833) 452-0726
NPI assigned
Jul 10, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 10, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy Assistant 224Z00000X OTA.5561 SC Primary

Addresses

Primary practice location

1849 Capri Dr
Charleston, SC 29407-7603

Mailing address

1849 Capri Dr
Charleston, SC 29407-7603
Phone (843) 224-3885

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

LicenseStateTypeSpecialty
OTA.5561SCMDOccupational Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Pluff Mud Children'S Therapy Occupational Therapy Assistant PastSince Jul 16, 2023 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.

NPI Registry JSON

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

{
    "created_epoch": "1688947200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1688947200000",
    "number": "1346928108",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1849 CAPRI DR",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294077603",
            "telephone_number": "843-224-3885",
            "fax_number": "833-452-0726"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1849 CAPRI DR",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294077603",
            "telephone_number": "843-224-3885",
            "fax_number": "833-452-0726"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BACHELDER",
        "first_name": "KYLEA",
        "middle_name": "JOY",
        "credential": "COTA/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-07-10",
        "last_updated": "2023-07-10",
        "certification_date": "2023-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "SC",
            "license": "OTA.5561",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charleston, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.