Active NPI
Kathleen Susanne Reynolds, MS OTR/L
- Occupational Therapist
- Williamsville, NY
National Provider Identifier
1477790822
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 008869
- Practice address
- 92 Devon LN
Williamsville, NY 14221-4914 - Phone
- (716) 984-3519
- NPI assigned
- Jan 7, 2009
- Sex
- Female
- Sole proprietor
- Yes
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 | 008869 | NY | Primary |
Addresses
Primary practice location
92 Devon LN
Williamsville, NY 14221-4914
Mailing address
92 Devon LN
Williamsville, NY 14221-4914
Phone (716) 984-3519
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 008869 | Other | NY | OCCUPATIONAL THERAPY LICENSE |
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
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 008869 | NY | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1231286400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1231286400000",
"number": "1477790822",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "92 DEVON LN",
"city": "WILLIAMSVILLE",
"state": "NY",
"postal_code": "142214914",
"telephone_number": "716-984-3519"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "92 DEVON LN",
"city": "WILLIAMSVILLE",
"state": "NY",
"postal_code": "142214914",
"telephone_number": "716-984-3519"
}
],
"practiceLocations": [],
"basic": {
"last_name": "REYNOLDS",
"first_name": "KATHLEEN",
"middle_name": "SUSANNE",
"name_prefix": "Mrs.",
"credential": "MS OTR/L",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2009-01-07",
"last_updated": "2009-01-07",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "NY",
"license": "008869",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "OCCUPATIONAL THERAPY LICENSE",
"identifier": "008869",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Williamsville, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.