Individual provider Active NPI

Keaira Renee Khaukha, OTR/L

  • Occupational Therapist
  • Papillion, NE
National Provider Identifier
1497165138
Registry record updated Mar 14, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
2767 Issued in NE
Practice address
5208 Timberridge Dr
Papillion, NE 68133-2759
Phone
(816) 859-0839
NPI assigned
May 3, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 14, 2023

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 2767 NE Primary

Addresses

Primary practice location

5208 Timberridge Dr
Papillion, NE 68133-2759

Mailing address

6681 Sorensen Pkwy
Omaha, NE 68152-2139
Phone (402) 932-8884

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231108001020 TX Practitioner - Occupational Therapist in Private Practice 4082061387 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2767NEMDOccupational Therapist
123631TXMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Synergy Care Southeast, LLC Occupational Therapist CurrentSince Oct 1, 2023 Accepting new patients

Locations

127 W Broad St
Ste 850
Lake Charles, LA 70601
Phone (337) 310-8500

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1399075200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678752000000",
    "number": "1497165138",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6681 SORENSEN PKWY",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681522139",
            "telephone_number": "402-932-8884",
            "fax_number": "402-932-8885"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5208 TIMBERRIDGE DR",
            "city": "PAPILLION",
            "state": "NE",
            "postal_code": "681332759",
            "telephone_number": "816-859-0839"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHAUKHA",
        "first_name": "KEAIRA",
        "middle_name": "RENEE",
        "credential": "OTR/L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-05-03",
        "last_updated": "2023-03-14",
        "certification_date": "2023-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NE",
            "license": "2767",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Papillion, NE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2023; 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.