Active NPI
Kim Kerlee, OT
- Occupational Therapist
- Pantego, TX
National Provider Identifier
1457083610
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 109558
- Practice address
- 2650 W Park Row Dr
Pantego, TX 76013-2270 - Phone
- (877) 367-9772
- NPI assigned
- Jun 27, 2022
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 109558 | TX | Primary |
Addresses
Primary practice location
2650 W Park Row Dr
Pantego, TX 76013-2270
Mailing address
2307 High Dr
Grapevine, TX 76051-4545
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 109558 | TX | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1656288000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1656288000000",
"number": "1457083610",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2307 HIGH DR",
"city": "GRAPEVINE",
"state": "TX",
"postal_code": "760514545"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2650 W PARK ROW DR",
"city": "PANTEGO",
"state": "TX",
"postal_code": "760132270",
"telephone_number": "877-367-9772"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KERLEE",
"first_name": "KIM",
"credential": "OT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-06-27",
"last_updated": "2022-06-27",
"certification_date": "2022-06-27",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "TX",
"license": "109558",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Pantego, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.