Individual provider Active NPI

Catelyn Skipper, OT

  • Occupational Therapist
  • Vicksburg, MS
National Provider Identifier
1497120240
Registry record updated Sep 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
OT3070 Issued in MS
Practice address
5473 Youngton Rd
Vicksburg, MS 39183-7924
Phone
(601) 415-5761
Fax
(601) 629-0502
NPI assigned
Dec 4, 2015
Last updated
Sep 13, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 13, 2026

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 OT3070 MS Primary

Addresses

Primary practice location

5473 Youngton Rd
Vicksburg, MS 39183-7924

Mailing address

5473 Youngton Rd
Vicksburg, MS 39183-7924
Phone (601) 415-5761

Other names 1

  • Catelyn Park Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170616001805 MS Practitioner - Occupational Therapist in Private Practice 7416230768 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OT3070MSMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Valley Therapy LLC Occupational Therapist Current Accepting new patients
Elite Performance and Rehab, LLC CurrentSince Feb 1, 2017 Accepting new patients
Good Samaritan Physical Therapy,Inc. Past Accepting new patients
Diagnostic Testing Solutions Past Accepting new patients

Locations

2080 S Frontage Rd
Ste 108
Vicksburg, MS 39180
Phone (601) 629-4304

Organizations & group practices 4

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": "1449187200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1789257600000",
    "number": "1497120240",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5473 YOUNGTON RD",
            "city": "VICKSBURG",
            "state": "MS",
            "postal_code": "391837924",
            "telephone_number": "601-415-5761",
            "fax_number": "601-629-0502"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5473 YOUNGTON RD",
            "city": "VICKSBURG",
            "state": "MS",
            "postal_code": "391837924",
            "telephone_number": "601-415-5761",
            "fax_number": "601-629-0502"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SKIPPER",
        "first_name": "CATELYN",
        "credential": "OT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-12-04",
        "last_updated": "2026-09-13",
        "certification_date": "2026-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "MS",
            "license": "OT3070",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CATELYN",
            "last_name": "PARK",
            "credential": "OT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Vicksburg, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.