Mark Charles Kahlbaugh, O.T.

Primary specialty

Pediatric Occupational TherapistTaxonomy code 225XP0200X

License

2559 Issued in AZ

Practice address

2093 E Willow Wick Rd
Gilbert, AZ 85296-2747

Phone

(480) 205-6917

Fax

(480) 361-4420

NPI assigned

Dec 8, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Altru Therapy, LLC

  • Home Health Agency
  • Mesa, AZ
  • NPI 1326770835
  NPD Authorized official
• Viking Therapy, LTD.

  • Home Health Agency
  • Gilbert, AZ
  • NPI 1114032000
  NPD (past) Authorized official

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

{
    "created_epoch": "1165536000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1366501702",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2093 E WILLOW WICK RD",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852962747",
            "telephone_number": "480-205-6917",
            "fax_number": "480-361-4420"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2093 E WILLOW WICK RD",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852962747",
            "telephone_number": "480-205-6917",
            "fax_number": "480-361-4420"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAHLBAUGH",
        "first_name": "MARK",
        "middle_name": "CHARLES",
        "name_prefix": "Mr.",
        "credential": "O.T.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-08",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "AZ",
            "license": "2559",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AZ STATE OT LICENSE",
            "identifier": "2559",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tami Jursich, BCBA
• Sarah Justiss, COTA/L
• Sumeet Kadakia, M.D.
• Aya Kadhom Abbas
• Madhuri Kadiyala, MD
• Diem-Thuy Kahlon, D.O.
• Lawrence Stephen Kahn, M.D.
• Erin Kahover, COTA/L
• Kairon Medical LLC
• Kairos Spine LLC

• Pediatric Occupational Therapist in Gilbert, AZ
• Providers in Gilbert, AZ by specialty
• Pediatric Occupational Therapist in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.