Individual provider Active NPI

Kipp Aaron Clayton, O.T.-R.

  • Occupational Therapist
  • Castroville, TX
National Provider Identifier
1568520641
Registry record updated Apr 16, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
109851 Issued in TX
Practice address
209 US Highway 90 W
Ste. 2
Castroville, TX 78009-4540
Phone
(830) 931-2211
Fax
(830) 538-3778
NPI assigned
Dec 4, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 16, 2008

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 109851 TX Primary

Addresses

Primary practice location

209 US Highway 90 W
Ste. 2
Castroville, TX 78009-4540

Mailing address

209 US Highway 90 West
Suite 2
Castroville, TX 78009-4555
Phone (830) 931-2211

Other identifiers 1

IdentifierTypeStateIssuer
89688TOtherTXBLUE CROSS BLUE SHIELD

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
109851TXMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
MV Spine and Joint, P.a. Past Accepting new patients
Medina Valley Spine and Joint, LLC Occupational Therapist PastSince May 7, 2008 Accepting new patients

Organizations & group practices 2

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": "1165190400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1208304000000",
    "number": "1568520641",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "209 US HIGHWAY 90 WEST",
            "address_2": "SUITE 2",
            "city": "CASTROVILLE",
            "state": "TX",
            "postal_code": "780094555",
            "telephone_number": "830-931-2211",
            "fax_number": "830-538-3778"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "209 US HIGHWAY 90 W",
            "address_2": "STE. 2",
            "city": "CASTROVILLE",
            "state": "TX",
            "postal_code": "780094540",
            "telephone_number": "830-931-2211",
            "fax_number": "830-538-3778"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLAYTON",
        "first_name": "KIPP",
        "middle_name": "AARON",
        "name_prefix": "Mr.",
        "credential": "O.T.-R.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-04",
        "last_updated": "2008-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "TX",
            "license": "109851",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "89688T",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Castroville, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 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.

Verify at the official NPI Registry.