Individual provider Active NPI

Kaitlin Anne Slade

  • Occupational Therapist
  • Norfolk, VA
National Provider Identifier
1376216127
Registry record updated May 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
0119010202 Issued in VA
Practice address
3900 Llewellyn Ave
Norfolk, VA 23504-1203
Phone
(757) 625-5363
NPI assigned
Jul 28, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 16, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 121781 TX
Occupational Therapist 225X00000X 0119010202 VA Primary

Addresses

Primary practice location

3900 Llewellyn Ave
Norfolk, VA 23504-1203

Mailing address

550 Sweetgrass LN
Jonesborough, TN 37659-4471
Phone (615) 715-8871

Electronic endpoints 2

TypeEndpointUseAffiliation
CONNECT URL https://www.cms.gov/research-statistics-data-systems/electronic-submission-medical-documentation-esmd/cms-health-information-handler Other Fox Rehabilitation Services of South Carolina, LLC
CONNECT URL https://www.cms.gov/research-statistics-data-systems/electronic-submission-medical-documentation-esmd/cms-health-information-handler Other Fox Rehabilitation Services of South Carolina, LLC

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250523001331 SC Practitioner - Occupational Therapist in Private Practice 0446779383 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Fox Rehabilitation Services of South Carolina, LLCGroup PAC ID 3971639998, 289 clinicians

Practice addresses (Care Compare)

800 N Lake Dr
Lexington, SC 29072-2903
Phone (877) 407-3422

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
7544SCMDPhysical Therapist
121781TXMDOccupational Therapist
0119010202VAMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Fox Rehabilitation Services of South Carolina, LLC Occupational Therapist CurrentSince May 1, 2025 Accepting new patients

Locations

7 Carnegie Plz
Cherry Hill, NJ 08003

1156 Bowman Rd
Unit 105
Mt Pleasant, SC 29464
Phone (843) 971-1233

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": "1627430400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747353600000",
    "number": "1376216127",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "550 SWEETGRASS LN",
            "city": "JONESBOROUGH",
            "state": "TN",
            "postal_code": "376594471",
            "telephone_number": "615-715-8871"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3900 LLEWELLYN AVE",
            "city": "NORFOLK",
            "state": "VA",
            "postal_code": "235041203",
            "telephone_number": "757-625-5363"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SLADE",
        "first_name": "KAITLIN",
        "middle_name": "ANNE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-07-28",
        "last_updated": "2025-05-16",
        "certification_date": "2025-05-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "TX",
            "license": "121781",
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "VA",
            "license": "0119010202",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://www.cms.gov/research-statistics-data-systems/electronic-submission-medical-documentation-esmd/cms-health-information-handler",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.13.34.110.1.998.01",
            "affiliationName": "Fox Rehabilitation Services of South Carolina, LLC",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "800 N Lake Dr",
            "city": "Lexington",
            "state": "SC",
            "country_code": "US",
            "postal_code": "290722903",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://www.cms.gov/research-statistics-data-systems/electronic-submission-medical-documentation-esmd/cms-health-information-handler",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.13.34.110.1.998.01",
            "affiliationName": "Fox Rehabilitation Services of South Carolina, LLC",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "1156 Bowman Rd Unit 105",
            "city": "MT Pleasant",
            "state": "SC",
            "country_code": "US",
            "postal_code": "294643803",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Norfolk, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.