Kalyra Ananda S Goodrich

Primary specialty

Pediatric Occupational TherapistTaxonomy code 225XP0200X

License

OT.0004466 Issued in CO

Practice address

3480 Ravencreek LN
Oviedo, FL 32766-7043

Phone

(407) 810-2225

NPI assigned

Jan 1, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• Larissa D Heck Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1167609600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1456272000000",
    "number": "1447317508",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "40 GRAND AVE",
            "city": "MANITOU SPRINGS",
            "state": "CO",
            "postal_code": "808291726",
            "telephone_number": "805-453-7743"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3480 RAVENCREEK LN",
            "city": "OVIEDO",
            "state": "FL",
            "postal_code": "327667043",
            "telephone_number": "407-810-2225"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOODRICH",
        "first_name": "KALYRA",
        "middle_name": "ANANDA S",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-01",
        "last_updated": "2016-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "FL",
            "license": "OT11677",
            "primary": false
        },
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "CO",
            "license": "OT.0004466",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "890148100",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "812089700",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LARISSA",
            "last_name": "HECK",
            "middle_name": "D",
            "credential": "OTR",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Diana Alexandra Gonzalez Batero, FNP-BC
• Ashley J Gonzalez Goytia, MD
• Katherine Gonzalez-Betancur, OTR/L
• Annjeanette Gonzalez, LMT
• Good Vibes Counseling LLC
• Laurie Anne Gordon
• Alyssa Gould
• Morly Gourdet, RBT
• Kristi Rae Grainger
• Kathryn Michelle Graves, ARNP

• Pediatric Occupational Therapist in Oviedo, FL
• Providers in Oviedo, FL by specialty
• Pediatric Occupational Therapist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2016; 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.