Active NPI
Kyla Thibault, OTR
- Occupational Therapist
- Colebrook, NH
National Provider Identifier
1497926067
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 0995
- Practice address
- 181 Corliss LN
Colebrook, NH 03576-3207 - Phone
- (603) 388-4206
- Fax
- (603) 237-6039
- NPI assigned
- Mar 21, 2008
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 072-0000165 | VT | |
| Occupational Therapist | 225X00000X | 0995 | NH | Primary |
Addresses
Primary practice location
181 Corliss LN
Colebrook, NH 03576-3207
Mailing address
181 Corliss LN
Colebrook, NH 03576-3207
Phone (603) 388-4206
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 |
|---|---|---|---|
| 072-0000165 | VT | MD | Occupational Therapist |
| 0995 | NH | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1206057600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1206057600000",
"number": "1497926067",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "181 CORLISS LN",
"city": "COLEBROOK",
"state": "NH",
"postal_code": "035763207",
"telephone_number": "603-388-4206",
"fax_number": "603-237-6039"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "181 CORLISS LN",
"city": "COLEBROOK",
"state": "NH",
"postal_code": "035763207",
"telephone_number": "603-388-4206",
"fax_number": "603-237-6039"
}
],
"practiceLocations": [],
"basic": {
"last_name": "THIBAULT",
"first_name": "KYLA",
"name_prefix": "Mrs.",
"credential": "OTR",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-03-21",
"last_updated": "2008-03-21",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "VT",
"license": "072-0000165",
"primary": false
},
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "NH",
"license": "0995",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Colebrook, NH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.