Individual provider Active NPI

Kim Marie Doyle, COTA/L

  • Specialist
  • Saint Cloud, FL
National Provider Identifier
1407014210
Registry record updated May 28, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
OTA284 Issued in FL
Practice address
3815 Blackberry Cir
Saint Cloud, FL 34769-1424
Phone
(407) 891-1084
Fax
(407) 957-7039
NPI assigned
May 28, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 28, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X OTA284 FL Primary

Addresses

Primary practice location

3815 Blackberry Cir
Saint Cloud, FL 34769-1424

Mailing address

3815 Blackberry Cir
Saint Cloud, FL 34769-1424
Phone (407) 891-1084

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
OTA284FLMDSpecialist

NPI Registry JSON

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

{
    "created_epoch": "1211932800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1211932800000",
    "number": "1407014210",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3815 BLACKBERRY CIR",
            "city": "SAINT CLOUD",
            "state": "FL",
            "postal_code": "347691424",
            "telephone_number": "407-891-1084",
            "fax_number": "407-957-7039"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3815 BLACKBERRY CIR",
            "city": "SAINT CLOUD",
            "state": "FL",
            "postal_code": "347691424",
            "telephone_number": "407-891-1084",
            "fax_number": "407-957-7039"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOYLE",
        "first_name": "KIM",
        "middle_name": "MARIE",
        "name_prefix": "Ms.",
        "credential": "COTA/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-05-28",
        "last_updated": "2008-05-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "FL",
            "license": "OTA284",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Cloud, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 2008; 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.