Individual provider Active NPI

Kendra Ann Piontek, MS OTR/L CLT

  • Occupational Therapist
  • Charleston, SC
National Provider Identifier
1508590050
Registry record updated Jul 11, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
5516 Issued in SC
Practice address
2387 Lantern St
Charleston, SC 29414-4850
Phone
(317) 750-9879
NPI assigned
Jul 11, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 11, 2022

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 5516 SC Primary

Addresses

Primary practice location

2387 Lantern St
Charleston, SC 29414-4850

Mailing address

2387 Lantern St
Charleston, SC 29414-4850
Phone (317) 750-9879

Other practice location 1

1556 Bluewater Way
Charleston, SC 29414-7925
Phone (802) 779-6142

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240607002992 SC Practitioner - Occupational Therapist in Private Practice 3870035678 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
5516SCMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Coastal Play 2 Grow Therapy, LLC Occupational Therapist CurrentSince May 13, 2024 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1657497600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1657497600000",
    "number": "1508590050",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2387 LANTERN ST",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294144850",
            "telephone_number": "317-750-9879"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2387 LANTERN ST",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294144850",
            "telephone_number": "317-750-9879"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1556 Bluewater Way",
            "address_purpose": "LOCATION",
            "city": "Charleston",
            "state": "SC",
            "postal_code": "294147925",
            "country_code": "US",
            "telephone_number": "802-779-6142",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PIONTEK",
        "first_name": "KENDRA",
        "middle_name": "ANN",
        "credential": "MS OTR/L CLT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-07-11",
        "last_updated": "2022-07-11",
        "certification_date": "2022-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "SC",
            "license": "5516",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charleston, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2022; 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.