Active NPI
Kathryn Richmond, OTR/L
- Pediatric Occupational Therapist
- Starke, FL
National Provider Identifier
1487645529
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Occupational Therapist
- License
- OT7497
- Practice address
- 2162 NE 154TH St
Starke, FL 32091-6418 - Phone
- (904) 964-4464
- Fax
- (904) 964-4279
- NPI assigned
- Oct 28, 2005
- 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 |
|---|---|---|---|---|
| Pediatric Occupational Therapist | 225XP0200X | OT7497 | FL | Primary |
Addresses
Primary practice location
2162 NE 154TH St
Starke, FL 32091-6418
Mailing address
2162 NE 154TH St
Starke, FL 32091-6418
Phone (904) 964-4464
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| OT7497 | FL | MD | Pediatric Occupational Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Kidtalk, P.a. | Pediatrics | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1130457600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183939200000",
"number": "1487645529",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2162 NE 154TH ST",
"city": "STARKE",
"state": "FL",
"postal_code": "320916418",
"telephone_number": "904-964-4464",
"fax_number": "904-964-4279"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2162 NE 154TH ST",
"city": "STARKE",
"state": "FL",
"postal_code": "320916418",
"telephone_number": "904-964-4464",
"fax_number": "904-964-4279"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RICHMOND",
"first_name": "KATHRYN",
"credential": "OTR/L",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-10-28",
"last_updated": "2007-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "225XP0200X",
"taxonomy_group": "",
"desc": "Occupational Therapist, Pediatrics",
"state": "FL",
"license": "OT7497",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Starke, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.