Katrina Dare, OT

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

OT006827 Issued in GA

Practice address

111 Renegar Way
Saint Simons Island, GA 31522-8840

Phone

(912) 291-2032

Fax

(912) 291-2095

NPI assigned

Sep 25, 2017

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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": "1506297600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1506297600000",
    "number": "1477062255",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "182 SOMERSBY POINTE",
            "city": "BRUNSWICK",
            "state": "GA",
            "postal_code": "315237076",
            "telephone_number": "413-320-8089"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 RENEGAR WAY",
            "city": "SAINT SIMONS ISLAND",
            "state": "GA",
            "postal_code": "315228840",
            "telephone_number": "912-291-2032",
            "fax_number": "912-291-2095"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DARE",
        "first_name": "KATRINA",
        "credential": "OT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-09-25",
        "last_updated": "2017-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "GA",
            "license": "OT006827",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Occupational Therapist in Saint Simons Island, GA
• Providers in Saint Simons Island, GA by specialty
• Occupational Therapist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 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.