Individual provider Active NPI

Kristy A Bautista, OTR/L

  • Occupational Therapist
  • Orlando, FL
National Provider Identifier
1396921680
Registry record updated Oct 3, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
OT13670 Issued in FL
Practice address
3305 S. Orange Avenue
Orlando, FL 32806
Phone
(407) 599-4001
NPI assigned
Jan 16, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 3, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X OT13670 FL Primary

Addresses

Primary practice location

3305 S. Orange Avenue
Orlando, FL 32806

Mailing address

3948 Lakeside Reserve LN
Orlando, FL 32810-2811
Phone (407) 376-0463

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
OT13670FLMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
United Cerebral Palsy of Central Florida, Inc. 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.

NPI Registry JSON

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

{
    "created_epoch": "1200441600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1506988800000",
    "number": "1396921680",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3948 LAKESIDE RESERVE LN",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328102811",
            "telephone_number": "407-376-0463"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3305 S. ORANGE AVENUE",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "32806",
            "telephone_number": "407-599-4001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAUTISTA",
        "first_name": "KRISTY",
        "middle_name": "A",
        "name_prefix": "Mrs.",
        "credential": "OTR/L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-01-16",
        "last_updated": "2017-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "FL",
            "license": "OT13670",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orlando, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2017; 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.