Active NPI
Kathy J Kichura, OTR/L
- Occupational Therapist
- Panama City, FL
National Provider Identifier
1356008270
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 1079
- Practice address
- 317 Highbrook Rd
Panama City, FL 32404-9811 - Phone
- (256) 541-5083
- NPI assigned
- Nov 27, 2021
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 1079 | FL | Primary |
Addresses
Primary practice location
317 Highbrook Rd
Panama City, FL 32404-9811
Mailing address
109 Candlewick Cir
Panama City, FL 32405-3257
Phone (850) 890-0229
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 |
|---|---|---|---|
| 1079 | FL | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1637971200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1638230400000",
"number": "1356008270",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "109 CANDLEWICK CIR",
"city": "PANAMA CITY",
"state": "FL",
"postal_code": "324053257",
"telephone_number": "850-890-0229"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "317 HIGHBROOK RD",
"city": "PANAMA CITY",
"state": "FL",
"postal_code": "324049811",
"telephone_number": "256-541-5083"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KICHURA",
"first_name": "KATHY",
"middle_name": "J",
"name_prefix": "Mrs.",
"credential": "OTR/L",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2021-11-27",
"last_updated": "2021-11-30",
"certification_date": "2021-11-30",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "FL",
"license": "1079",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Panama City, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.