Individual provider Active NPI

Kathryn Delaughter, OTR/L

  • Occupational Therapist
  • Cordova, TN
National Provider Identifier
1457873408
Registry record updated Oct 29, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
5696 Issued in TN
Practice address
36 Bazeberry Rd
Cordova, TN 38018-7754
Phone
(901) 758-0036
NPI assigned
Jul 12, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 29, 2019

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 5696 TN Primary

Addresses

Primary practice location

36 Bazeberry Rd
Cordova, TN 38018-7754

Mailing address

1803 Adair Bridge CV
Germantown, TN 38138-3107

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL NA Other

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220803002630 TN Practitioner - Occupational Therapist in Private Practice 5294117511 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Aegis Group Practice LLCGroup PAC ID 5193036432, 399 clinicians
Healthpro Heritage Rehab and Fitness LLCGroup PAC ID 6507832573, 976 clinicians

Practice addresses (Care Compare)

601 Wolf River Blvd
Collierville, TN 38017-6600
Phone (901) 883-0348

6605 N Quail Hollow Rd
Memphis, TN 38120-1323
Phone (901) 613-4064

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Healthpro Heritage Rehab & Fitness, LLC Occupational Therapist CurrentSince Jun 27, 2022 Accepting new patients
Aegis Group Practice LLC Occupational Therapist Current Accepting new patients
Aegis Group Practice LLC Occupational Therapist CurrentSince Oct 2, 2023 Accepting new patients
Ave Maria Home CurrentSince Feb 13, 2023 Accepting new patients
Healthpro Heritage Rehab & Fitness, LLC Occupational Therapist CurrentSince Jun 27, 2022 Accepting new patients
Aegis Group Practice LLC Occupational Therapist CurrentSince Oct 2, 2023 Accepting new patients

Locations

4933 Old Greenwood Rd
Fort Smith, AR 72903

3345 Kirby Whitten Rd
Bartlett, TN 38134
Phone (901) 245-4395

2805 Charles Bryan Rd
Bartlett, TN 38134
Phone (901) 386-3211

960 S Seivers Blvd
Clinton, TN 37716
Phone (865) 270-3178

Organizations & group practices 51

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.

View all 51

NPI Registry JSON

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

{
    "created_epoch": "1499817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1572307200000",
    "number": "1457873408",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1803 ADAIR BRIDGE CV",
            "city": "GERMANTOWN",
            "state": "TN",
            "postal_code": "381383107"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "36 BAZEBERRY RD",
            "city": "CORDOVA",
            "state": "TN",
            "postal_code": "380187754",
            "telephone_number": "901-758-0036"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DELAUGHTER",
        "first_name": "KATHRYN",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-07-12",
        "last_updated": "2019-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "TN",
            "license": "5696",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "NA",
            "affiliation": "N",
            "endpointDescription": "NA",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "NA",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "36 Bazeberry Rd",
            "city": "Cordova",
            "state": "TN",
            "country_code": "US",
            "postal_code": "380187754",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Cordova, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2019; 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.